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      Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

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    Patent Pending

    Clinical Pulmonary Infection Score (CPIS) for Ventilator-Associated Pneumonia (VAP)

    Assists in diagnosing ventilator-associated pneumonia by predicting benefit of pulmonary cultures.

    IMPORTANT

    We launched a COVID-19 Resource Center, including a critical review of recommended calcs. 

    INSTRUCTIONS

    Many reviews of the CPIS feel it should not be relied on; we include it because of its popularity but caution users to review the data on its utility first.
    When to Use
    Pearls/Pitfalls
    Why Use

    Patients being evaluated for possible ventilator-associated pneumonia.

    The CPIS, at a cut-off of >6 points to diagnose ventilator-associated pneumonia (VAP), seems poorly sensitive and specific. The few derivation, validation, and autopsy studies, mostly with small selected cohorts, suggest the score may be inaccurate. However, a reasonable reference standard for defining VAP remains elusive, making this a tricky analysis.

    VAP is a tricky diagnosis with many confounders. Using a scoring system may be better than using common clinical gestalt.

    36.5-38.4
    0
    38.5-38.9
    +1
    ≥39.0 or ≤36.0
    +2
    4-11
    0
    <4 or >11
    +1
    Either <4 or >11 plus band forms ≥500
    +2
    <14+
    0
    ≥14+
    +1
    ≥14+ plus purulent secretions
    +2
    >240 or ARDS
    0
    ≤240 and no ARDS
    +2
    No infiltrate
    0
    Diffuse or patchy infiltrate
    +1
    Localized infiltrate
    +2
    Pathogenic bacteria cultured ≤1 or no growth
    0
    Pathogenic bacteria cultured >1+
    +1
    Pathogenic bacteria cultured >1+ plus same pathogenic bacteria on gram stain >1+
    +2
    Confirmed positive
    Suspected
    Unlikely
    Confirmed negative

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Carolina A.M. Schurink

    About the Creator

    Carolina A.M. Schurink, MD, is a professor of medicine and practicing physician at the Erasmus University Medical Center in Rotterdam, Netherlands.

    To view Dr. Carolina A.M. Schurink's publications, visit PubMed

    Are you Dr. Carolina A.M. Schurink? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Dr. Carolina A.M. Schurink
    Are you Dr. Carolina A.M. Schurink?