APACHE II for Predicting Course and Outcome of Nosocomial Staphylococcus aureus Bacteremia and Its Relation to Host Defense

Yzerman, Ed P. F.; Boelens, Hélène; Tjhie, Jeroen H. T.; Kluytmans, Jan; Mouton, Johan W.; Verbrugh, Henri A.

doi:10.1093/infdis/173.4.914

Cited by 54 publications

(46 citation statements)

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“…Nevertheless, the APACHE score (APACHE II or APACHE III), based on the worst parameters within the first 48 h of the positive blood culture, has consistently been established as an independent predictor of mortality, with an incremental increase in mortality rates as scores increase (204,301,324). Multiple other scoring systems have been developed, all of which have been shown to be predictors of mortality (167,202).…”

Section: Shock/sepsis and Severity Of Illnessmentioning

confidence: 99%

Predictors of Mortality in Staphylococcus aureus Bacteremia

et al. 2012

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SUMMARY Staphylococcus aureus bacteremia (SAB) is an important infection with an incidence rate ranging from 20 to 50 cases/100,000 population per year. Between 10% and 30% of these patients will die from SAB. Comparatively, this accounts for a greater number of deaths than for AIDS, tuberculosis, and viral hepatitis combined. Multiple factors influence outcomes for SAB patients. The most consistent predictor of mortality is age, with older patients being twice as likely to die. Except for the presence of comorbidities, the impacts of other host factors, including gender, ethnicity, socioeconomic status, and immune status, are unclear. Pathogen-host interactions, especially the presence of shock and the source of SAB, are strong predictors of outcomes. Although antibiotic resistance may be associated with increased mortality, questions remain as to whether this reflects pathogen-specific factors or poorer responses to antibiotic therapy, namely, vancomycin. Optimal management relies on starting appropriate antibiotics in a timely fashion, resulting in improved outcomes for certain patient subgroups. The roles of surgery and infectious disease consultations require further study. Although the rate of mortality from SAB is declining, it remains high. Future international collaborative studies are required to tease out the relative contributions of various factors to mortality, which would enable the optimization of SAB management and patient outcomes.

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Section: Shock/sepsis and Severity Of Illnessmentioning

confidence: 99%

Predictors of Mortality in Staphylococcus aureus Bacteremia

et al. 2012

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“…All the 21 articles included were cohort studies, 15 were prospective and six retrospective [ (13,(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36) and (37)(38)(39)(40)(41)(42), respectively]. The study population in 15 of the articles was defined by the fulfillment of two or more SIRS criteria (13,24,(27)(28)(29)(30)32,33,(35)(36)(37)(39)(40)(41)(42).…”

Section: Resultsmentioning

confidence: 99%

“…The study population in 15 of the articles was defined by the fulfillment of two or more SIRS criteria (13,24,(27)(28)(29)(30)32,33,(35)(36)(37)(39)(40)(41)(42). In five articles, the suspicion of infection was given only by the request to take hemocultures (23,25,26,31,38). In only one study were both criteria taken into account (34).…”

Section: Resultsmentioning

confidence: 99%

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Usefulness of Severity Scores in Patients with Suspected Infection in the Emergency Department: A Systematic Review

Calle

Cerro

Valencia

et al. 2012

The Journal of Emergency Medicine

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“…Although chronic health points clearly contribute to the global assessment of intensive care unit mortality risk, it is less clear whether such patients are optimal candidates for therapeutic interventions with experimental agents. Furthermore, the use of APACHE II score when the patient is already in the ICU has never been properly validated, although some studies have suggested using the changes in (delta) APACHE II [76,77]. Another problem associated with severity scores is their influence by the lead-time bias.…”

Section: Cns Failurementioning

confidence: 99%