The significance of modified PIRO scoring with nlr biomarker on enhancing mortality prediction of patients with ventilators-associated pneumonia in intensive care unit

Abstract

Ventilator-associated pneumonia (VAP) is a pulmonary infection that occurs as a mechanical ventilator-related disease which accounts for almost 80% of hospital-acquired pneumonia with of high mortality rate, lengthens the hospital-stay rate and increases health costs. To provide a description of the likelihood of the patient' s life expectancy, mortality, and prognosis of patients in ICU, a scoring system should be utilized in order to assess the severity of the disease and estimate mortality during hospital treatment. The PIRO scoring system is a comprehensive concept that provides good validity and derivation in predicting mortality risk in a wide range severity of the disease so that it is very useful in the selection or categorization of patients, especially those admitted to the ICU with VAP. A conjunction or integration with a simple biomarker such as Neutrophil-to-lymphocyte ratio (NLR) provides a better performance of the tool in regards to the predictive value in VAP mortality risk estimation. Since the NLR has a strong predictive value, is simple, lowcost, and easily available compared to other biomarkers, therefore it is practical and useful for prognostic indications for VAP with conjunction with the PIRO score where medical facilities are lacking.