The Evaluation Of CPIS Score And ASS Score In Severe Craniocerebral Injury Secondary Infection

Objective: to analysis severe craniocerebral injury secondaryinfection, discuss the value of the clinical pulmonary infection score（CPIS score）and the adjusted score of SIRS（ASS score）in severecraniocerebral injury secondary infection. To provide the basis as a guideand an evidence of clinical treatment and prognosis assessmentsMetheods: Analyse the103severely craniocerebral injured patientsthat were cured from January2009to January2011in neurosurgery of ourhospital. The materials of infection rate, infection time, the main types ofinfection and the main cause of death were collected. CPIS score and ASSscore were statistical analysis for the patients. The outcome endpointswere the ICU stay time,the hospitalization time and the infection controltime, and among them the hospital mortality was the primary outcomeendpoint.The predictive power was contrasted in the scores according toreceiver operating characteristiccurve(ROC curve).Results the infection rate in severe craniocerebral injury is muchhigher than the average infection rate of hospital(P<0.05). The lower GCS scores were, the higher the infection rate was (P<0.05). The peak ofinfection were7days in hospital. The lung infection was the mostimportant type of infection. The multiple organ dysfunction syndrome(MODS) caused by the acute respiratory distress syndrome （SIRS）wasthe main cause of death. There was significant difference in the CPISscore between the dead group and the survivors （Z=3.444，P=0.0003<0.01）,so as to the ASS score(t=6.26，P<0.01). The ICU staytime, the hospitalization time and the infection control time werepositively correlated with the ASS score（r=0.695p=0.000， r=0.725P=0.000，r=0.707P=0.000）. These results suggest that CPIS scores andASS scores have a good calibration for predicting mortality in patientsaccording to the area under the ROC curve(AUC)（0.835，0.836）. Thebest diagnostic threshold of the CPIS score was7, the ASS scores was11. The sensitivity and specificity of predicted mortality were79.9%、92.3%and73.2%、96.2%.Conclusion1、There was more secondary infection in the severecraniocerebral injury patients, and the lower GCS scores were, the higherthe infection rate were. The peak of infection were7days in hospital. Thelung infection was the most important type of infection. The multipleorgan dysfunction syndrome (MODS) caused by the acute respiratorydistress syndrome （SIRS）was the main cause of death.2、These results suggest that CPIS scores and ASS scores have a good calibration for predicting mortality in patients of severe craniocerebralinjury secondary infection.