Study on the predictive value of APACHE II score and neurogenic dysphagia in carbapenem-resistant Klebsiella pneumoniae

Carbapenem-resistant Klebsiella pneumoniae (CRKP) poses a growing challenge in clinical treatment globally. Early identification of high-risk patients is essential to control infection spread and improve treatment outcomes. This retrospective study analyzed 152 patients with K pneumoniae infections at the Second People's Hospital of Hefei City, Anhui Province, dividing them into carbapenem-resistant and non-carbapenem-resistant groups. Clinical data, microbiological test results, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, and neurogenic dysphagia status were evaluated to identify risk factors for CRKP infection. The study revealed that patients in the carbapenem-resistant group had significantly higher APACHE II scores and a higher incidence of neurogenic dysphagia (P < 0.05). Multivariate logistic regression analysis identified APACHE II scores and neurogenic dysphagia as independent risk factors for CRKP infection. Receiver operating characteristic curve analysis showed an area under the curve of 0.824 (95% confidence interval: 0.749-0.898) for the APACHE II score, with an optimal threshold of 14.5 points. A new predictive model combining neurogenic dysphagia with APACHE II scores improved classification performance, as demonstrated by Net Reclassification Improvement (NRI = 0.0967, 95% confidence interval: -0.0477 to 0.2410) and reclassification probability analysis, correctly reclassifying 24.32% of individuals into a higher risk category. The findings highlight the combined predictive value of APACHE II scores and neurogenic dysphagia for early identification and intervention in high-risk CRKP patients.