Lung Injury Prediction Score Is Useful in Predicting Acute Respiratory Distress Syndrome and Mortality in Surgical Critical Care Patients.
Bottom Line: Background.Methods.Conclusion.
Affiliation: Henry Ford Hospital, Detroit, MI 48202, USA.
Background. Lung injury prediction score (LIPS) is valuable for early recognition of ventilated patients at high risk for developing acute respiratory distress syndrome (ARDS). This study analyzes the value of LIPS in predicting ARDS and mortality among ventilated surgical patients. Methods. IRB approved, prospective observational study including all ventilated patients admitted to the surgical intensive care unit at a single tertiary center over 6 months. ARDS was defined using the Berlin criteria. LIPS were calculated for all patients and analyzed. Logistic regression models evaluated the ability of LIPS to predict development of ARDS and mortality. A receiver operator characteristic (ROC) curve demonstrated the optimal LIPS value to statistically predict development of ARDS. Results. 268 ventilated patients were observed; 141 developed ARDS and 127 did not. The average LIPS for patients who developed ARDS was 8.8 ± 2.8 versus 5.4 ± 2.8 for those who did not (p < 0.001). An ROC area under the curve of 0.79 demonstrates LIPS is statistically powerful for predicting ARDS development. Furthermore, for every 1-unit increase in LIPS, the odds of developing ARDS increase by 1.50 (p < 0.001) and odds of ICU mortality increase by 1.22 (p < 0.001). Conclusion. LIPS is reliable for predicting development of ARDS and predicting mortality in critically ill surgical patients.
No MeSH data available.
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Mentions: A total of 268 patients were enrolled in the study. 155 (57.8%) patients were male (p = 0.738). 99 (36.9%) were African American, 147 (54.9%) were Caucasian, and 22 (8.2%) were of other race (p = 0.584). The average age was 57.9 ± 17.7 years. A total of 141 (52.6%) patients developed ARDS and 127 (47.4%) patients did not develop ARDS. The LIPS for patients who developed ARDS was statistically significantly higher than for those patients who did not develop ARDS. Table 2 shows the average LIPS for a patient who developed ARDS was 8.8 ± 2.8 and the LIPS for a patient who did not develop ARDS was 5.4 ± 2.8. Figure 1 goes on to illustrate the distribution of LIPS in patients with and without ARDS. Patients who develop ARDS tend to have higher Lung Injury Prediction Scores. Furthermore, using logistic regression modeling, for every one-unit increase in LIP score, the odds of developing ARDS increased by a factor of 1.50 (95% confidence interval: 1.34, 1.67; p < 0.001).
No MeSH data available.