The Role of APACHE II Scoring System On The Development And Outcome Of VAP In Intensive Care Unit

Abstract

OBJECTIVE: is to find out the role of APACHE II scoring system on the development and outcome of VAP, and also to investigate the pathogens with their susceptibility pattern related with VAP.METHODOLOGY: This prospective cohort study of 90 patients was conducted in ICU of Lady Reading Hospital, Peshawar. APACHE II ("Acute Physiology and Chronic Health Evaluation II") score was calculated for every patient and is a severity of disease classification system, one of several ICU scoring systems. It was applied within 24 hours of admission of a patient to an ICU. VAP was recognized using CPIS of greater than 6. The incidence of VAP, death, frequency organisms isolated, their antibiotic sensitivity pattern, length of hospital stay & mechanical ventilation were evaluated.RESULTS: Elevated APACHE II score was associated with high mortality rate and increased incidence of VAP. Mortality in non-VAP group was 44%, while 68.29% was in VAP group. Majority strains of Pseudomonas (38.46%) were resistant to beta-lactam antibiotics. All strains of staphylococcus aureus were MRSA and majority isolates of Klebsiella pneumoniae (54.54%) were extended-spectrum beta–lactamase generating. Mortality was greatest for infections of Acinetobacter baumannii (83.33%) and Klebsiella pneumoniae (54.53%).CONCLUSION: APACHE II score can be used to stratify the risk of development of VAP and overall risk of death. Drug-resistant strains of a variety of pathogens are the main cause of VAP in our set up.