年龄、动脉血氧分压/吸入氧分数值比值及平台压评分（APPS）对入住重症监护病房的新型冠状病毒肺炎相关急性呼吸窘迫综合征患者死亡率的预后评估效能
Prognostic performance of the Age, PaO/FiO Ratio, and Plateau Pressure Score (APPS) for mortality in patients with COVID-19-associated acute respiratory distress syndrome admitted to an intensive care unit.
作者信息
Gutierrez-Zamudio Alfredo A M, Alejandro-Salinas Rodrigo, Vereau-Robles Jose I, Toro-Huamanchumo Carlos J
机构信息
School of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, Peru.
Sociedad Científica de Estudiantes de Medicina - UPC, Lima, Peru.
出版信息
Ther Adv Infect Dis. 2024 Dec 13;11:20499361241306212. doi: 10.1177/20499361241306212. eCollection 2024 Jan-Dec.
BACKGROUND
A predictive scoring system used in patients with acute respiratory distress syndrome (ARDS) known as Age, PaO/FiO, Plateau Pressure Score (APPS) has been externally validated to predict mortality in Asian and Caucasian populations. Its performance in Latin American and COVID-19 patients still needs to be done.
OBJECTIVE
To assess the association between APPS and mortality, as well as APPS performance in predicting mortality within 28 days of intensive care unit (ICU) admission in patients with ARDS due to COVID-19.
DESIGN
Analytical observational retrospective cohort study.
METHODS
We conducted a retrospective cohort study in patients diagnosed with ARDS according to the Berlin criteria who were admitted to the ICU. We evaluated the prognostic performance of APPS using the area under the receiver operating characteristic curve (AUC-ROC), and association with mortality was measured using the Cox proportional hazards regression models.
RESULTS
A total of 271 patients were analyzed. The AUC for 28-day mortality was 0.78 (95% CI: 0.73-0.84). In the Cox proportional hazards model, after adjusting for sex and categorized Charlson Comorbidity Index, it was found that grade 2 APPS (aHR: 3.67, 95% CI: 2.14-6.30, < 0.001) and grade 3 APPS (aHR: 7.95, 95% CI: 3.72-17.02, < 0.001) were associated with a higher hazard of 28-day mortality.
CONCLUSION
The APPS scoring system has a good prognostic performance for mortality in patients diagnosed with COVID-19-induced ARDS.
背景
一种用于急性呼吸窘迫综合征（ARDS）患者的预测评分系统，即年龄、动脉血氧分压/吸入氧分数值、平台压评分（APPS），已在亚洲和白种人群体中进行了外部验证，以预测死亡率。其在拉丁美洲和新冠肺炎患者中的表现仍有待研究。
目的
评估APPS与死亡率之间的关联，以及APPS在预测因新冠肺炎导致ARDS的患者入住重症监护病房（ICU）后28天内死亡率方面的表现。
设计
分析性观察性回顾性队列研究。
方法
我们对根据柏林标准诊断为ARDS并入住ICU的患者进行了回顾性队列研究。我们使用受试者操作特征曲线下面积（AUC-ROC）评估APPS的预后表现，并使用Cox比例风险回归模型测量与死亡率的关联。
结果
共分析了271例患者。28天死亡率的AUC为0.78（95%CI：0.73-0.84）。在Cox比例风险模型中，在调整性别和分类的Charlson合并症指数后，发现2级APPS（调整后风险比：3.67，95%CI：2.14-6.30，P<0.001）和3级APPS（调整后风险比：7.95，95%CI：3.72-17.02，P<0.001）与28天死亡率的较高风险相关。
结论
APPS评分系统对诊断为新冠肺炎诱发ARDS的患者的死亡率具有良好的预后表现。
Zotero 插件