The Use of Scoring Systems to Predict Prognosis in Patients With Ventilator-associated Pneumonia

Ventilator-associated pneumonia (VAP) is associated with significant morbidity and mortality in critically ill patients, despite recent advances in prevention and treatment. A simple and accurate scoring system is needed for stratifying mortality risk in these patients, which is necessary for anticipating clinical failure, prolonged mechanical ventilation, and prolonged intensive care unit stay, and for comparing and evaluating clinical trials to improve clinical decision making. Severity scoring systems developed for critically ill patients, such as Acute Physiology and Chronic Health Evaluation II, Sepsis-Related Organ Failure Assessment, and Simplified Acute Physiology Score II, have historically been used to predict mortality risk in patients with VAP, as a scoring system had not been developed specifically for VAP. However, many of these scoring systems are cumbersome to use and few have been well validated in subsets of critically ill populations with VAP. An alternative scoring system is needed for determining mortality risk in these patients that is easy to use clinically. The IBMP-10 and the PIRO are 2 proposed scoring systems. The purpose of this review is to evaluate the validity of these scoring systems for predicting prognosis in patients with VAP specifically.