Division of Pulmonology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
Department of Critical Care Medicine, Korea University Ansan Hospital, Ansan, Korea.
Yonsei Med J. 2021 May;62(5):417-423. doi: 10.3349/ymj.2021.62.5.417.
Early recognition and therapeutic intervention are important in patients at high risk of acute respiratory distress syndrome (ARDS). The lung injury prediction score (LIPS) has been used to predict ARDS development; however, it was developed based on the previous definition of ARDS. We investigated the predictive role of LIPS in ARDS development according to its Berlin definition in the Korean population.
This was a retrospective study that enrolled adult patients admitted to the intensive care unit (ICU) at a single university-affiliated hospital in Korea from September 1, 2018, to August 31, 2019. LIPS at the time of ICU admission and the development of ARDS were evaluated.
Of the 548 enrolled patients, 33 (6.0%) fulfilled the Berlin ARDS definition. The LIPS for non-ARDS and ARDS groups were 4.96±3.05 and 8.53±2.45, respectively (<0.001); it was significantly associated with ARDS development (odds ratio 1.48, 95% confidence interval, 1.29-1.69; <0.001). LIPS >6 predicted the development of ARDS with a sensitivity of 84.8% and a specificity of 67.2% [area under the curve (AUC)=0.82]. A modified LIPS model adjusted for age and severity at ICU admission predicted ICU mortality in patients with ARDS (AUC=0.80), but not in those without ARDS (AUC=0.54).
LIPS predicted the development of ARDS as diagnosed by the Berlin definition in the Korean population. LIPS provides useful information for managing patients with ARDS.
在有发生急性呼吸窘迫综合征(ARDS)风险的患者中,早期识别和治疗干预非常重要。肺损伤预测评分(LIPS)已被用于预测 ARDS 的发生;然而,它是基于 ARDS 的先前定义开发的。我们在韩国人群中根据柏林定义调查了 LIPS 在 ARDS 发生中的预测作用。
这是一项回顾性研究,纳入了 2018 年 9 月 1 日至 2019 年 8 月 31 日期间在韩国一家大学附属医院重症监护病房(ICU)住院的成年患者。评估 ICU 入院时的 LIPS 和 ARDS 的发生情况。
在纳入的 548 名患者中,33 名(6.0%)符合柏林 ARDS 定义。非 ARDS 和 ARDS 组的 LIPS 分别为 4.96±3.05 和 8.53±2.45(<0.001);与 ARDS 的发生显著相关(比值比 1.48,95%置信区间,1.29-1.69;<0.001)。LIPS >6 预测 ARDS 的发生具有 84.8%的敏感性和 67.2%的特异性(曲线下面积(AUC)=0.82)。调整 ICU 入院时年龄和严重程度的改良 LIPS 模型预测 ARDS 患者 ICU 死亡率(AUC=0.80),但不能预测非 ARDS 患者的 ICU 死亡率(AUC=0.54)。
LIPS 预测了韩国人群中根据柏林定义诊断的 ARDS 的发生。LIPS 为 ARDS 患者的管理提供了有用的信息。