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Medicina crítica (Colegio Mexicano de Medicina Crítica)

versión impresa ISSN 2448-8909

Resumen

TORRES GARCIA, Job et al. APP score (Age, PaO2/FiO2, Plateau) predict mortality in septic shock of pulmonary etiology. Med. crít. (Col. Mex. Med. Crít.) [online]. 2023, vol.37, n.8, pp.646-651.  Epub 11-Mar-2025. ISSN 2448-8909.  https://doi.org/10.35366/115221.

Introduction:

about 70% of patients with septic shock will require mechanical ventilation (MV), with the main site of infection being the lung. Prognostic scales help in decision making, so they must be easy, reproducible and specific to each pathology. The APP score (Age, PaO2/FiO2, Plateau) is an instrument that can help us classify mortality individually.

Objective:

to evaluate the usefulness of the APP score to predict mortality in pulmonary septic shock.

Material and methods:

cohort, retrospective, observational, analytical study. It was carried out in the Intensive Care Unit (ICU) in the period from May 5, 2015, to December 31, 2019. It consisted of a review of medical records. The population was classified into group 1 APP score ≤ 6 points and group 2 APP score > 6 points, the outcome was followed up in the ICU.

Results:

35 patients were included, group 1 included 18 patients and 17 patients for group 2. Mortality in group 1 was 39% and 59% for group 2 p = 0.86. The APP score > 6 points presented OR 1.12 (95% CI 1.06-4.24) p = 0.04 for mortality. The PM (mechanical power) > 22 J/min reported AUC 0.77, p = 0.02.

Conclusion:

in pulmonary septic shock, having an APP score > 6 points increases mortality. We must determine the prognosis of patients individually, based on the main organ involved, otherwise, we could underestimate mortality when using general prognostic scales.

Palabras llave : septic shock; APP score; mechanical ventilation; mortality.

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