Infection probability score, APACHE II and KARNOFSKY scoring systems as predictors of infection onset in haematology–oncology patients

Aim. To assess the predictive power of three systems: Infection Probability Score, APACHE II and KARNOFSKY score to the onset of healthcare‐associated infections in haematology–oncology patients. Background. The high incidence of healthcare‐associated infections is a frequent problem in haematology–oncology patients that affects morbidity and mortality of these patients. Design. A retrospective surveillance survey. Method. The survey was conducted for seven months in the haematology unit of a general hospital in Greece to assess the predictive power of Infection Probability Score, APACHE II and KARNOFSKY score to the onset of healthcare‐associated infections. The sample consisted of 102 hospitalised patients. The diagnosis of healthcare‐associated infections was based on the definitions proposed by CDC. Results. Among the participants, 53 (52%) were males and 49 (48%) were females with a mean age of 53·30 (SD 18·59) years old (range, 17–85 years). The incidence density of healthcare‐associated infections (the number of new cases of healthcare‐associated infections per 1000 patient‐days) was 21·8 infections per 1000 patient‐days. Among the 102 patients, healthcare‐associated infections occurred in 32 (31·4%) patients who had a total of 48 healthcare‐associated infections (47·5%). Among the 38 patients with neutropenia, 26 (68·4%) had more than one healthcare‐associated infection. Of the 48 detected healthcare‐associated infections, the most frequent type was blood‐stream infection (n = 17, 35·4%), followed by Clostridium difficile infection (n = 11, 22·9%) and respiratory tract infection (n = 8, 3·4%). The best cut‐off value of Infection Probability Score (IPS) for the prediction of a healthcare‐associated infection was 10 with sensitivity of 59·4% and specificity of 74·3%. Conclusions. Between the three different prognostic scoring systems, IPS had the best sensitivity in predicting healthcare‐associated infections. Relevance to clinical practice. IPS is an effective tool and should be used from nurses for the early detection of haematology–oncology patients who are susceptible to the onset of a healthcare‐associated infection.