Alveolar Arterial Gradient and Respiratory Index in Predicting the Outcome of COVID-19 Patients; a Retrospective Cross-Sectional Study
Introduction: Alveolar arterial (A-a) oxygen gradient and respiratory index can be of immense help for the critical care physician in clinical decision making. This study aimed to evaluate the potential application of A-a oxygen gradient and respiratory index in predicting the survival of COVID-19...
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| Format: | Article |
| Language: | English |
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Shahid Beheshti University of Medical Sciences
2022-04-01
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| Series: | Archives of Academic Emergency Medicine |
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| Online Access: | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1543 |
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| author | Abhishek Singh Kapil Dev Soni Yudhyavir Singh Richa Aggarwal Vineeta Venkateswaran Mohd Suhail Ashar Anjan Trikha |
| author_facet | Abhishek Singh Kapil Dev Soni Yudhyavir Singh Richa Aggarwal Vineeta Venkateswaran Mohd Suhail Ashar Anjan Trikha |
| author_sort | Abhishek Singh |
| collection | DOAJ |
| description |
Introduction: Alveolar arterial (A-a) oxygen gradient and respiratory index can be of immense help for the critical care physician in clinical decision making. This study aimed to evaluate the potential application of A-a oxygen gradient and respiratory index in predicting the survival of COVID-19 patients in intensive care unit (ICU).
Method: This is a retrospective cross-sectional study involving 215 adult patients with COVID-19 disease, admitted to the ICU between 1st April 2020 and 30 June 2021. Details regarding demographic variables, comorbidities, laboratory and arterial blood gas (ABG) findings were recorded. Alveolar-arterial gradient and respiratory index were calculated and tested as predictors of survival.
Result: The mean age of the patients was 51.92 years (65.6 % male). Hypertension was the most common comorbidity and oxygen via non-rebreathing mask was the most common modality used at the time of ICU admission. Mortality was 28.37% and average length of stay was 12.84 days. Patients who died were older (p=0.02), mostly male (p=0.017), had at least one comorbidity (p<0.001), and higher heart rate and respiratory rate (<0.001 and p=0.03, respectively), lower pH on arterial blood gas (ABG) (p=0.002), higher FiO2 requirement (p<0.001), and increased A-a oxygen gradient on admission compared to survivors. According to receiver operating characteristic (ROC) curve analysis, A-a oxygen gradient and respiratory index were not sensitive or specific in predicting mortality in the studied patient subset.
Conclusion: A-a oxygen gradient and respiratory index calculated at time of admission to ICU in patients with COVID-19 were poor predictors of survival.
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| first_indexed | 2024-04-13T17:08:00Z |
| format | Article |
| id | doaj.art-78d6e61b450044ae93579608557c2503 |
| institution | Directory Open Access Journal |
| issn | 2645-4904 |
| language | English |
| last_indexed | 2024-04-13T17:08:00Z |
| publishDate | 2022-04-01 |
| publisher | Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | Archives of Academic Emergency Medicine |
| spelling | doaj.art-78d6e61b450044ae93579608557c25032022-12-22T02:38:24ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042022-04-0110110.22037/aaem.v10i1.1543Alveolar Arterial Gradient and Respiratory Index in Predicting the Outcome of COVID-19 Patients; a Retrospective Cross-Sectional StudyAbhishek Singh0Kapil Dev SoniYudhyavir SinghRicha AggarwalVineeta VenkateswaranMohd Suhail AsharAnjan TrikhaALL INDIA INSTITUTE OF MEDICAL SCIENCES, NEW DELHI Introduction: Alveolar arterial (A-a) oxygen gradient and respiratory index can be of immense help for the critical care physician in clinical decision making. This study aimed to evaluate the potential application of A-a oxygen gradient and respiratory index in predicting the survival of COVID-19 patients in intensive care unit (ICU). Method: This is a retrospective cross-sectional study involving 215 adult patients with COVID-19 disease, admitted to the ICU between 1st April 2020 and 30 June 2021. Details regarding demographic variables, comorbidities, laboratory and arterial blood gas (ABG) findings were recorded. Alveolar-arterial gradient and respiratory index were calculated and tested as predictors of survival. Result: The mean age of the patients was 51.92 years (65.6 % male). Hypertension was the most common comorbidity and oxygen via non-rebreathing mask was the most common modality used at the time of ICU admission. Mortality was 28.37% and average length of stay was 12.84 days. Patients who died were older (p=0.02), mostly male (p=0.017), had at least one comorbidity (p<0.001), and higher heart rate and respiratory rate (<0.001 and p=0.03, respectively), lower pH on arterial blood gas (ABG) (p=0.002), higher FiO2 requirement (p<0.001), and increased A-a oxygen gradient on admission compared to survivors. According to receiver operating characteristic (ROC) curve analysis, A-a oxygen gradient and respiratory index were not sensitive or specific in predicting mortality in the studied patient subset. Conclusion: A-a oxygen gradient and respiratory index calculated at time of admission to ICU in patients with COVID-19 were poor predictors of survival. https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1543COVID-19critical careblood gas analysespulmonary gas exchangerespiratory system abnormalities |
| spellingShingle | Abhishek Singh Kapil Dev Soni Yudhyavir Singh Richa Aggarwal Vineeta Venkateswaran Mohd Suhail Ashar Anjan Trikha Alveolar Arterial Gradient and Respiratory Index in Predicting the Outcome of COVID-19 Patients; a Retrospective Cross-Sectional Study Archives of Academic Emergency Medicine COVID-19 critical care blood gas analyses pulmonary gas exchange respiratory system abnormalities |
| title | Alveolar Arterial Gradient and Respiratory Index in Predicting the Outcome of COVID-19 Patients; a Retrospective Cross-Sectional Study |
| title_full | Alveolar Arterial Gradient and Respiratory Index in Predicting the Outcome of COVID-19 Patients; a Retrospective Cross-Sectional Study |
| title_fullStr | Alveolar Arterial Gradient and Respiratory Index in Predicting the Outcome of COVID-19 Patients; a Retrospective Cross-Sectional Study |
| title_full_unstemmed | Alveolar Arterial Gradient and Respiratory Index in Predicting the Outcome of COVID-19 Patients; a Retrospective Cross-Sectional Study |
| title_short | Alveolar Arterial Gradient and Respiratory Index in Predicting the Outcome of COVID-19 Patients; a Retrospective Cross-Sectional Study |
| title_sort | alveolar arterial gradient and respiratory index in predicting the outcome of covid 19 patients a retrospective cross sectional study |
| topic | COVID-19 critical care blood gas analyses pulmonary gas exchange respiratory system abnormalities |
| url | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/1543 |
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