Categorizing Acute Respiratory Distress Syndrome with Different Severities by Oxygen Saturation Index
The oxygen saturation index (OSI), defined by F<sub>I</sub>O<sub>2</sub>/S<sub>p</sub>O<sub>2</sub> multiplied by the mean airway pressure, has been reported to exceed the Berlin definition in predicting the mortality of acute respiratory distress synd...
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| Format: | Article |
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MDPI AG
2023-12-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/14/1/37 |
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| author | Shin-Hwar Wu Chew-Teng Kor Shu-Hua Chi Chun-Yu Li |
| author_facet | Shin-Hwar Wu Chew-Teng Kor Shu-Hua Chi Chun-Yu Li |
| author_sort | Shin-Hwar Wu |
| collection | DOAJ |
| description | The oxygen saturation index (OSI), defined by F<sub>I</sub>O<sub>2</sub>/S<sub>p</sub>O<sub>2</sub> multiplied by the mean airway pressure, has been reported to exceed the Berlin definition in predicting the mortality of acute respiratory distress syndrome (ARDS). The OSI has served as an alternative to the Berlin definition in categorizing pediatric ARDS. However, the use of the OSI for the stratification of adult ARDS has not been reported. A total of 379 invasively ventilated adult ARDS patients were retrospectively studied. The ARDS patients were classified into three groups by their incidence rate of mortality: mild (OSI < 14.69), moderate (14.69 < OSI < 23.08) and severe (OSI > 23.08). OSI-based categorization was highly correlated with the Berlin definition by a Kendall’s tau of 0.578 (<i>p</i> < 0.001). The Kaplan–Meier curves of the three OSI-based groups were significantly different (<i>p</i> < 0.001). By the Berlin definition, the hazard ratio for 28-day mortality was 0.58 (0.33–1.05) and 0.95 (0.55–1.67) for the moderate and severe groups, respectively (compared to the mild group). In contrast, the corresponding hazard ratio was 1.01 (0.69–1.47) and 2.39 (1.71–3.35) for the moderate and severe groups defined by the OSI. By multivariate analysis, OSI-based severe ARDS was independently associated with 28-D or 90-D mortality. In conclusion, we report the first OSI-based stratification for adult ARDS and find that it serves well as an alternative to the Berlin definition. |
| first_indexed | 2024-03-08T15:09:53Z |
| format | Article |
| id | doaj.art-e4e3799f294a48d0bb443b66e3ab4d43 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-08T15:09:53Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-e4e3799f294a48d0bb443b66e3ab4d432024-01-10T14:53:43ZengMDPI AGDiagnostics2075-44182023-12-011413710.3390/diagnostics14010037Categorizing Acute Respiratory Distress Syndrome with Different Severities by Oxygen Saturation IndexShin-Hwar Wu0Chew-Teng Kor1Shu-Hua Chi2Chun-Yu Li3Division of Critical Care Internal Medicine, Department of Emergency Medicine and Critical Care, Changhua Christian Hospital, Changhua 50006, TaiwanBig Data Center, Changhua Christian Hospital, Changhua 50006, TaiwanSection of Respiratory Therapy, Department of Emergency Medicine and Critical Care, Changhua Christian Hospital, Changhua 50006, TaiwanSection of Respiratory Therapy, Department of Emergency Medicine and Critical Care, Changhua Christian Hospital, Changhua 50006, TaiwanThe oxygen saturation index (OSI), defined by F<sub>I</sub>O<sub>2</sub>/S<sub>p</sub>O<sub>2</sub> multiplied by the mean airway pressure, has been reported to exceed the Berlin definition in predicting the mortality of acute respiratory distress syndrome (ARDS). The OSI has served as an alternative to the Berlin definition in categorizing pediatric ARDS. However, the use of the OSI for the stratification of adult ARDS has not been reported. A total of 379 invasively ventilated adult ARDS patients were retrospectively studied. The ARDS patients were classified into three groups by their incidence rate of mortality: mild (OSI < 14.69), moderate (14.69 < OSI < 23.08) and severe (OSI > 23.08). OSI-based categorization was highly correlated with the Berlin definition by a Kendall’s tau of 0.578 (<i>p</i> < 0.001). The Kaplan–Meier curves of the three OSI-based groups were significantly different (<i>p</i> < 0.001). By the Berlin definition, the hazard ratio for 28-day mortality was 0.58 (0.33–1.05) and 0.95 (0.55–1.67) for the moderate and severe groups, respectively (compared to the mild group). In contrast, the corresponding hazard ratio was 1.01 (0.69–1.47) and 2.39 (1.71–3.35) for the moderate and severe groups defined by the OSI. By multivariate analysis, OSI-based severe ARDS was independently associated with 28-D or 90-D mortality. In conclusion, we report the first OSI-based stratification for adult ARDS and find that it serves well as an alternative to the Berlin definition.https://www.mdpi.com/2075-4418/14/1/37acute respiratory distress syndromeclassificationmortalityoxygen saturation index |
| spellingShingle | Shin-Hwar Wu Chew-Teng Kor Shu-Hua Chi Chun-Yu Li Categorizing Acute Respiratory Distress Syndrome with Different Severities by Oxygen Saturation Index Diagnostics acute respiratory distress syndrome classification mortality oxygen saturation index |
| title | Categorizing Acute Respiratory Distress Syndrome with Different Severities by Oxygen Saturation Index |
| title_full | Categorizing Acute Respiratory Distress Syndrome with Different Severities by Oxygen Saturation Index |
| title_fullStr | Categorizing Acute Respiratory Distress Syndrome with Different Severities by Oxygen Saturation Index |
| title_full_unstemmed | Categorizing Acute Respiratory Distress Syndrome with Different Severities by Oxygen Saturation Index |
| title_short | Categorizing Acute Respiratory Distress Syndrome with Different Severities by Oxygen Saturation Index |
| title_sort | categorizing acute respiratory distress syndrome with different severities by oxygen saturation index |
| topic | acute respiratory distress syndrome classification mortality oxygen saturation index |
| url | https://www.mdpi.com/2075-4418/14/1/37 |
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