Kang Hye-Rin, Kim Dong Jung, Lee Jinwoo, Cho Young-Jae, Kim Jun Sung, Lee Sang-Min, Lee Jae-Ho, Jheon Sanghoon, Lee Choon-Taek, Lee Yeon Joo
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Jongno-gu, Seoul.
Department of Thoracic and Cardiovascular Surgery, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.
Ann Thorac Surg. 2017 Sep;104(3):797-803. doi: 10.1016/j.athoracsur.2017.01.052. Epub 2017 Apr 12.
Venovenous (VV) extracorporeal membrane oxygenation (ECMO) can be a life-saving therapy for patients with severe acute lung failure refractory to conventional therapy. The respiratory ECMO survival prediction (RESP) score and the predicting death for severe acute respiratory distress syndrome on VV-ECMO (PRESERVE) score were created to predict survival at the time of initiation of ECMO. This study aimed to validate both of these scores externally and to compare their predictive accuracies in patients with non-Western acute respiratory distress syndrome (ARDS).
In this retrospective cohort study, we reviewed and extracted data from electronic medical records of consecutive adult ARDS patients who were treated with VV-ECMO from 2007 to 2015. The PRESERVE and RESP scores were calculated for each patient. The outcomes of interest were inhospital and 6-month survival.
In all, 99 patients were included. The mean age of the patients was 54 years, and male patients constituted 70% of the cohort. The inhospital and 6-month survival rates were 23% and 22%, respectively. Receiver-operating characteristics curve analysis of the PRESERVE and RESP scores showed area under the curve values of 0.64 and 0.69, respectively (p = 0.53), for inhospital survival. The receiver-operating characteristics areas under the curve for 6-month survival were 0.66 and 0.69, respectively (p = 0.68). The prognostic accuracies of the PRESERVE and RESP scores were thus similar.
Both PRESERVE and RESP scores are useful for predicting survival in Asian ARDS patients, and both scores had similar prognostic accuracies in our Korean ARDS cohort.
静脉-静脉（VV）体外膜肺氧合（ECMO）对于常规治疗无效的严重急性肺衰竭患者而言，可能是一种挽救生命的治疗方法。呼吸ECMO生存预测（RESP）评分和VV-ECMO上严重急性呼吸窘迫综合征死亡预测（PRESERVE）评分用于预测ECMO启动时的生存情况。本研究旨在对这两种评分进行外部验证，并比较它们在非西方急性呼吸窘迫综合征（ARDS）患者中的预测准确性。
在这项回顾性队列研究中，我们回顾并提取了2007年至2015年接受VV-ECMO治疗的连续性成年ARDS患者的电子病历数据。为每位患者计算PRESERVE和RESP评分。感兴趣的结局为住院期间和6个月生存率。
总共纳入了99例患者。患者的平均年龄为54岁，男性患者占队列的70%。住院期间和6个月生存率分别为23%和22%。PRESERVE和RESP评分的受试者工作特征曲线分析显示，住院期间生存的曲线下面积值分别为0.64和0.69（p = 0.53）。6个月生存的受试者工作特征曲线下面积分别为0.66和0.69（p = 0.68）。因此，PRESERVE和RESP评分的预后准确性相似。
PRESERVE和RESP评分均有助于预测亚洲ARDS患者的生存情况，且在我们的韩国ARDS队列中，这两种评分的预后准确性相似。
