Comparing the APACHE II score and IBM-10 score for predicting mortality in patients with ventilator-associated pneumonia

Abstract

BACKGROUND: VAP is defined as pneumonia in patients who use ventilators. The acute physiology and chronic health evaluation (APACHE II) scoring system was originally developed for predicting mortality in patients who were admitted to the intensive care unit. Due to the complexity, a simpler score called IBMP-10 was developed. We designed the study to confirm and further investigate these two methods. MATERIALS AND METHODS: This cross-sectional and analysis-descriptive study was done at the moment of VAP diagnosis on 60 patients in intensive care units. APACHE II and the IBMP-10 scores were calculated. ROC curves were generated to compare the new prediction rule with the APACHE II score. Results were reported as adjusted odds ratios with 95 confidence intervals (CIs). Analyses were performed using SPSS, version 20 and P values of 0.05 were considered to be statistically significant. RESULTS: APACHE II Score means (P < 0.001) and IBMP-10 score (P < 0.001) means had significant increase in Non-survivor patient than in patients who survived. APACHE II can be used as a good prediction measure for mortality rate. In IBMP-10 method, specificity and PPV were greater than APACHE II, but in mc-nemar test, there was no significant difference between the two methods (P = 0.55). Both prediction rules had high NPV. In our study, survivors' prediction value in APACHE II was 46.7, and in IBMP-10, it was 46.7. CONCLUSION: IBMP-10, compared to APACHE II, has greater sensitivity, specificity, and AUC to predict mortality. So the consequence of the use of IBMP-10 was better than APACHE II.