SEVERITY OF ILLNESS CLASSIFICATION FOR INFECTION-CONTROL DEPARTMENTS - A STUDY IN NOSOCOMIAL PNEUMONIA

Background: A subjective severity of illness classification was evalua ted in a study of nosocomial pneumonia. This is a 5-category system ba sed on the determination of the control of underlying illness and the risk of death during current hospital admission. Methods: A case-contr ol study was performed with 128 cases of nosocomial pneumonia and 252 control patients. An additional 60 case and 90 control patients were u sed to compare this classification with APACHE II scoring in intensive care unit patients. Results: In univariate analysis, the severity ill ness classification was significantly associated with nosocomial pneum onia risk (p < 0.01). APACHE II adequately predicted mortality rate bu t was not statistically significantly associated with nosocomial pneum onia risk among intensive care unit patients. In logistic regression a nalysis, the severity of illness classification, surgery, age, nasogas tric tube placement, and histamine blockers each showed significant in dependent association with nosocomial pneumonia. Conclusions: The role of the severity of illness classification for risk stratification in nosocomial pneumonia is valid. Its roles in the evaluation of surgical wound infection, nosocomial bacteremia, and quality of care remain to be determined in subsequent studies.