Evaluation of the SpO2/FiO2 ratio as a predictor of intensive care unit transfers in respiratory ward patients for whom the rapid response system has been activated
| Autor: | In-Ae Song, Yeon Joo Lee, Hyunju Min, Young Jae Cho, Jae Ho Lee, Sang Hoon Lee, Ho Il Yoon, You Hwan Jo, Dong Seon Lee, Yun Young Choi, Choon Taek Lee, Youlim Kim, Jongsun Park, Won Gun Kwack, Miae Yun |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Critical Care and Emergency Medicine Pulmonology Physiology lcsh:Medicine Blood Pressure Vascular Medicine law.invention 0302 clinical medicine Interquartile range law Heart Rate Medicine and Health Sciences Medicine Coronary Heart Disease Hospital Mortality Oximetry lcsh:Science Acute Respiratory Distress Syndrome Aged 80 and over Multidisciplinary Respiration Early warning score Prognosis Intensive care unit Hospitals Respiratory Function Tests Intensive Care Units Chemistry Inhalation Predictive value of tests Physical Sciences Female Rapid response system Research Article Chemical Elements Patient Transfer medicine.medical_specialty Critical Care Critical Illness Cardiology 03 medical and health sciences Oxygen Consumption Respiratory Failure Predictive Value of Tests Humans Respiratory Physiology Aged Retrospective Studies Noninvasive Ventilation Receiver operating characteristic business.industry lcsh:R Biology and Life Sciences 030208 emergency & critical care medicine Retrospective cohort study Mews Health Care Oxygen 030228 respiratory system Health Care Facilities Emergency medicine lcsh:Q business Physiological Processes |
| Zdroj: | PLoS ONE PLoS ONE, Vol 13, Iss 7, p e0201632 (2018) |
| ISSN: | 1932-6203 |
| Popis: | Efforts to detect patient deterioration early have led to the development of early warning score (EWS) models. However, these models are disease-nonspecific and have shown variable accuracy in predicting unexpected critical events. Here, we propose a simpler and more accurate method for predicting risk in respiratory ward patients. This retrospective study analyzed adult patients who were admitted to the respiratory ward and detected using the rapid response system (RRS). Study outcomes included transfer to the intensive care unit (ICU) within 24 hours after RRS activation and in-hospital mortality. Prediction power of existing EWS models including Modified EWS (MEWS), National EWS (NEWS), and VitalPAC EWS (ViEWS) and SpO2/FiO2 (SF) ratio were compared to each other using the area under the receiver operating characteristic curve (AUROC). Overall, 456 patients were included; median age was 75 years (interquartile range: 65-80) and 344 (75.4%) were male. Seventy-three (16.0%) and 79 (17.3%) patients were transferred to the ICU and died. The SF ratio displayed better or comparable predictive accuracy for unexpected ICU transfer (AUROC: 0.744) compared to MEWS (0.744 vs. 0.653, P = 0.03), NEWS (0.744 vs. 0.667, P = 0.04), and ViEWS (0.744 vs. 0.675, P = 0.06). For in-hospital mortality, although there was no statistical difference, the AUROC of the SF ratio (0.660) was higher than that of each of the preexisting EWS models. In comparison with the preexisting EWS models, the SF ratio showed better or comparable predictive accuracy for unexpected ICU transfers in the respiratory wards. |
| Databáze: | OpenAIRE |
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