Disease Risk and Mortality Prediction in Intensive Care Patients with Pneumonia. Australian and New Zealand Practice in Intensive Care (ANZPIC II)

Boots, Rob; Lipman, Jeffrey; Bellomo, Rinaldo; Stephens, Dianne P.; Heller, Richard

doi:10.1177/0310057x0503300116

Cited by 28 publications

(21 citation statements)

References 52 publications

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“…Comparisons and contrasts between CAP, HAP and VAP are limited. This study and its companion studies describe the clinical practice, disease risk 16 , outcome predictors 16 and factors affecting clinical decision making 17 for pneumonia managed in Australian and New Zealand ICUs.…”

Section: Discussionmentioning

confidence: 99%

The Spectrum of Practice in the Diagnosis and Management of Pneumonia in Patients Requiring Mechanical Ventilation. Australian and New Zealand Practice in Intensive Care (ANZPIC II)

Boots

Lipman

Bellomo³

et al. 2005

Anaesth Intensive Care

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This study of ventilated patients investigated current clinical practice in 476 episodes of pneumonia (48% community-acquired pneumonia, 24% hospital-acquired pneumonia, 28% ventilator-associated pneumonia) using a prospective survey in 14 intensive care units (ICUs) within Australia and New Zealand. Diagnostic methods and confidence, disease severity, microbiology and antibiotic use were assessed. All pneumonia types had similar mortality (community-acquired pneumonia 33%, hospital-acquired pneumonia 37% and ventilator-associated pneumonia 24%, P=0.15) with no inter-hospital differences (P=0.08-0.91).

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Section: Discussionmentioning

confidence: 99%

The Spectrum of Practice in the Diagnosis and Management of Pneumonia in Patients Requiring Mechanical Ventilation. Australian and New Zealand Practice in Intensive Care (ANZPIC II)

Boots

Lipman

Bellomo³

et al. 2005

Anaesth Intensive Care

Self Cite

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“… 11–15 This is reflected in lack of consensus about the diagnosis of VAP in Australia and New Zealand, 16 with few healthcare facilities routinely collecting VAP data. 17 While a 2005 study across 14 ICUs revealed a rate of 28%, 18 bi-national rates are currently unknown. Effective and systematic VAP prevention strategies are limited by this lack of consensus.…”

Section: Introductionmentioning

confidence: 99%

Incidence of ventilator-associated pneumonia in Australasian intensive care units: use of a consensus-developed clinical surveillance checklist in a multisite prospective audit

Elliott,

Burrell

et al. 2015

BMJ Open

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ObjectivesWith disagreements on diagnostic criteria for ventilator-associated pneumonia (VAP) hampering efforts to monitor incidence and implement preventative strategies, the study objectives were to develop a checklist for clinical surveillance of VAP, and conduct an audit in Australian/New Zealand intensive care units (ICUs) using the checklist.SettingOnline survey software was used for checklist development. The prospective audit using the checklist was conducted in 10 ICUs in Australia and New Zealand.ParticipantsChecklist development was conducted with members of a bi-national professional society for critical care physicians using a modified Delphi technique and survey. A 30-day audit of adult patients mechanically ventilated for >72 h.Primary and secondary outcome measuresPresence of items on the screening checklist; physician diagnosis of VAP, clinical characteristics, investigations, treatments and patient outcome.ResultsA VAP checklist was developed with five items: decreasing gas exchange, sputum changes, chest X-ray infiltrates, inflammatory response, microbial growth. Of the 169 participants, 17% (n=29) demonstrated characteristics of VAP using the checklist. A similar proportion had an independent physician diagnosis (n=30), but in a different patient subset (only 17% of cases were identified by both methods). The VAP rate per 1000 mechanical ventilator days for the checklist and clinician diagnosis was 25.9 and 26.7, respectively. The item ‘inflammatory response’ was most associated with the first episode of physician-diagnosed VAP.ConclusionsVAP rates using the checklist and physician diagnosis were similar to ranges reported internationally and in Australia. Of note, different patients were identified with VAP by the checklist and physicians. While the checklist items may assist in identifying patients at risk of developing VAP, and demonstrates synergy with the recently developed Centers for Disease Control (CDC) guidelines, decision-making processes by physicians when diagnosing VAP requires further exploration.

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“…Although the SOFA score was not intended to predict mortality, it has been used for this purpose. Its simplicity and efficacy when compared to much more complex and sophisticated prognostic scoring systems (1)(2)(3)(4)(5)(6)(7)(8)(9) have led to its recent popularity and more frequent use beyond the sepsis setting for which it was originally developed [10][11][12][13][14][15] . More recently, the SOFA has been compared to other scores such as the APACHE and SAPS to evaluate patients with hematological malignancies and performed satisfactorily [16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

Automating and simplifying the SOFA score in critically ill patients with cancer

Nates

Cardenas‐Turanzas

Wakefield

et al. 2010

Health Informatics J

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The aim was to demonstrate the performance of a modified version of the Sequential Organ Failure Assessment (SOFA) score to predict mortality in medical and surgical patients with cancer. We performed an electronic retrospective review of databases. We included adult patients with cancer admitted into a 53-bed ICU over 28 months. We electronically calculated a modified SOFA (mSOFA) score at admission. A majority of the patients were admitted into the surgical ICU. Of 328 nonsurvivors, 85.1 per cent were medical patients and only 14.9 per cent surgical patients. The mean admission mSOFA scores for medical and surgical patients were 4.7 +/- 3.2 and 1.7 +/- 1.9, respectively. The overall area under the curve (AUC) of the mSOFA score was 0.84. The AUCs for medical and surgical patients were 0.72 and 0.78, respectively. Our results demonstrate that electronic assessment of mSOFA score has potential in resource allocation decisions as well as in critical care outreach programs.

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Disease Risk and Mortality Prediction in Intensive Care Patients with Pneumonia. Australian and New Zealand Practice in Intensive Care (ANZPIC II)

Cited by 28 publications

References 52 publications

The Spectrum of Practice in the Diagnosis and Management of Pneumonia in Patients Requiring Mechanical Ventilation. Australian and New Zealand Practice in Intensive Care (ANZPIC II)

The Spectrum of Practice in the Diagnosis and Management of Pneumonia in Patients Requiring Mechanical Ventilation. Australian and New Zealand Practice in Intensive Care (ANZPIC II)

Incidence of ventilator-associated pneumonia in Australasian intensive care units: use of a consensus-developed clinical surveillance checklist in a multisite prospective audit

Automating and simplifying the SOFA score in critically ill patients with cancer

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