Scoring systems for prediction of mortality in patients with intensive care unit-acquired sepsis: a comparison of the Pitt bacteremia score and the Acute Physiology and Chronic Health Evaluation II scoring systems

Shock. 2009 Feb;31(2):146-50. doi: 10.1097/SHK.0b013e318182f98f.

Abstract

This study compares the effectiveness of the Pitt bacteremia score, the Charlson weighted index of comorbidity, and the Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring systems for the prediction of mortality in intensive care unit (ICU) patients with sepsis using the retrospective observational method on 134 patients with ICU-acquired sepsis. The statistical analyses show several important findings. First, Pitt bacteremia score is significantly correlated with the APACHE II scoring system (correlation coefficient = 0.738, P < 0.001). Second, the APACHE II scoring system, the Pitt bacteremia score, and the Charlson weighted index of comorbidity are independently correlated with mortality. Third, the Pitt bacteremia score and the APACHE II scores are positively related to mortality in patients with ICU-acquired sepsis. As the result of the analyses, the mortality rate in patients with sepsis in the ICU is better predicted with the Pitt bacteremia score because it provides better estimation of sensitivity and specificity than the APACHE II scoring system and the Charlson weighted index of comorbidity.

MeSH terms

  • APACHE
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteremia / classification*
  • Bacteremia / diagnosis
  • Comorbidity
  • Critical Care / methods
  • Female
  • Humans
  • Intensive Care Units / classification*
  • Intensive Care Units / standards
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sepsis / classification*
  • Sepsis / diagnosis