New method of classifying infections in critically ill patients.

Abstract

To develop a systematic classification describing the contribution made by infection to the outcome from sepsis. The emergence of effective therapies for sepsis means that accurate methods of risk assessment are of increasing importance. Although there are well-validated instruments for describing risk factors in the host, the contribution made by the infection is less well served. A systematic literature review of the English language literature published during the last 30 yrs of studies describing the outcome of infections, categorized by micro-organism and site of infection. We surveyed 510 published articles including 55,854 clinical infections, and we generated specific risk codes for bacteremia, meningitis, pneumonia, skin and soft tissue infections, peritonitis, and urinary tract infections. Both the nature of the organisms and the site of infection have a significant impact on survival from sepsis, and there is a significant interaction between them. We have described a novel approach to permit a better assessment of the contribution made by the infection to mortality in patients with sepsis or septic shock.