Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study

Background Currently there is no ARDS definition or classification system that allows optimal prediction of mortality in ARDS patients. This study aimed to examine the predictive values of the AECC and Berlin definitions, as well as clinical and respiratory parameters obtained at onset of ARDS and i...
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Autor*in:	Balzer, Felix [verfasserIn] Menk, Mario Ziegler, Jannis Pille, Christian Wernecke, Klaus-Dieter Spies, Claudia Schmidt, Maren Weber-Carstens, Steffen Deja, Maria

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2016

Schlagwörter:	Acute respiratory distress syndrome Pao2/FIO2 ratio Oxygenation index Classification Risk stratification Outcome

Anmerkung:	© The Author(s). 2016

Übergeordnetes Werk:	Enthalten in: BMC anesthesiology - [S.l.] : BioMed Central, 2001, 16(2016), 1 vom: 08. Nov.
Übergeordnetes Werk:	volume:16 ; year:2016 ; number:1 ; day:08 ; month:11

Links:	Volltext

DOI / URN:	10.1186/s12871-016-0272-4

Katalog-ID:	SPR027322300

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520			\|a Background Currently there is no ARDS definition or classification system that allows optimal prediction of mortality in ARDS patients. This study aimed to examine the predictive values of the AECC and Berlin definitions, as well as clinical and respiratory parameters obtained at onset of ARDS and in the course of the first seven consecutive days. Methods The observational study was conducted at a 14-bed intensive care unit specialized on treatment of ARDS. Predictive validity of the AECC and Berlin definitions as well as $ P_{a} %$ O_{2} $/$ F_{i} %$ O_{2} $ and $ F_{i} %$ O_{2} $/$ P_{a} %$ O_{2} $*$ P_{mean} $ (oxygenation index) on mortality of ARDS patients was assessed and statistically compared. Results Four hundred forty two critically-ill patients admitted for ARDS were analysed. Multivariate Cox regression indicated that the oxygenation index was the most accurate parameter for mortality prediction. The third day after ARDS criteria were met at our hospital was found to represent the best compromise between earliness and accuracy of prognosis of mortality regarding the time of assessment. An oxygenation index of 15 or greater was associated with higher mortality, longer length of stay in ICU and hospital and longer duration of mechanical ventilation. In addition, non-survivors had a significantly longer length of stay and duration of mechanical ventilation in referring hospitals before admitted to the national reference centre than survivors. Conclusions The oxygenation index is suggested to be the most suitable parameter to predict mortality in ARDS, preferably assessed on day 3 after admission to a specialized centre. Patients might benefit when transferred to specialized ICU centres as soon as possible for further treatment.
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allfields	10.1186/s12871-016-0272-4 doi (DE-627)SPR027322300 (SPR)s12871-016-0272-4-e DE-627 ger DE-627 rakwb eng Balzer, Felix verfasserin (orcid)0000-0003-1575-2056 aut Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2016 Background Currently there is no ARDS definition or classification system that allows optimal prediction of mortality in ARDS patients. This study aimed to examine the predictive values of the AECC and Berlin definitions, as well as clinical and respiratory parameters obtained at onset of ARDS and in the course of the first seven consecutive days. Methods The observational study was conducted at a 14-bed intensive care unit specialized on treatment of ARDS. Predictive validity of the AECC and Berlin definitions as well as $ P_{a} %$ O_{2} $/$ F_{i} %$ O_{2} $ and $ F_{i} %$ O_{2} $/$ P_{a} %$ O_{2} $*$ P_{mean} $ (oxygenation index) on mortality of ARDS patients was assessed and statistically compared. Results Four hundred forty two critically-ill patients admitted for ARDS were analysed. Multivariate Cox regression indicated that the oxygenation index was the most accurate parameter for mortality prediction. The third day after ARDS criteria were met at our hospital was found to represent the best compromise between earliness and accuracy of prognosis of mortality regarding the time of assessment. An oxygenation index of 15 or greater was associated with higher mortality, longer length of stay in ICU and hospital and longer duration of mechanical ventilation. In addition, non-survivors had a significantly longer length of stay and duration of mechanical ventilation in referring hospitals before admitted to the national reference centre than survivors. Conclusions The oxygenation index is suggested to be the most suitable parameter to predict mortality in ARDS, preferably assessed on day 3 after admission to a specialized centre. Patients might benefit when transferred to specialized ICU centres as soon as possible for further treatment. Acute respiratory distress syndrome (dpeaa)DE-He213 Pao2/FIO2 ratio (dpeaa)DE-He213 Oxygenation index (dpeaa)DE-He213 Classification (dpeaa)DE-He213 Risk stratification (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Menk, Mario aut Ziegler, Jannis aut Pille, Christian aut Wernecke, Klaus-Dieter aut Spies, Claudia aut Schmidt, Maren aut Weber-Carstens, Steffen aut Deja, Maria aut Enthalten in BMC anesthesiology [S.l.] : BioMed Central, 2001 16(2016), 1 vom: 08. Nov. (DE-627)355422115 (DE-600)2091252-3 1471-2253 nnns volume:16 year:2016 number:1 day:08 month:11 https://dx.doi.org/10.1186/s12871-016-0272-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 08 11
spelling	10.1186/s12871-016-0272-4 doi (DE-627)SPR027322300 (SPR)s12871-016-0272-4-e DE-627 ger DE-627 rakwb eng Balzer, Felix verfasserin (orcid)0000-0003-1575-2056 aut Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2016 Background Currently there is no ARDS definition or classification system that allows optimal prediction of mortality in ARDS patients. This study aimed to examine the predictive values of the AECC and Berlin definitions, as well as clinical and respiratory parameters obtained at onset of ARDS and in the course of the first seven consecutive days. Methods The observational study was conducted at a 14-bed intensive care unit specialized on treatment of ARDS. Predictive validity of the AECC and Berlin definitions as well as $ P_{a} %$ O_{2} $/$ F_{i} %$ O_{2} $ and $ F_{i} %$ O_{2} $/$ P_{a} %$ O_{2} $*$ P_{mean} $ (oxygenation index) on mortality of ARDS patients was assessed and statistically compared. Results Four hundred forty two critically-ill patients admitted for ARDS were analysed. Multivariate Cox regression indicated that the oxygenation index was the most accurate parameter for mortality prediction. The third day after ARDS criteria were met at our hospital was found to represent the best compromise between earliness and accuracy of prognosis of mortality regarding the time of assessment. An oxygenation index of 15 or greater was associated with higher mortality, longer length of stay in ICU and hospital and longer duration of mechanical ventilation. In addition, non-survivors had a significantly longer length of stay and duration of mechanical ventilation in referring hospitals before admitted to the national reference centre than survivors. Conclusions The oxygenation index is suggested to be the most suitable parameter to predict mortality in ARDS, preferably assessed on day 3 after admission to a specialized centre. Patients might benefit when transferred to specialized ICU centres as soon as possible for further treatment. Acute respiratory distress syndrome (dpeaa)DE-He213 Pao2/FIO2 ratio (dpeaa)DE-He213 Oxygenation index (dpeaa)DE-He213 Classification (dpeaa)DE-He213 Risk stratification (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Menk, Mario aut Ziegler, Jannis aut Pille, Christian aut Wernecke, Klaus-Dieter aut Spies, Claudia aut Schmidt, Maren aut Weber-Carstens, Steffen aut Deja, Maria aut Enthalten in BMC anesthesiology [S.l.] : BioMed Central, 2001 16(2016), 1 vom: 08. Nov. (DE-627)355422115 (DE-600)2091252-3 1471-2253 nnns volume:16 year:2016 number:1 day:08 month:11 https://dx.doi.org/10.1186/s12871-016-0272-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 08 11
allfields_unstemmed	10.1186/s12871-016-0272-4 doi (DE-627)SPR027322300 (SPR)s12871-016-0272-4-e DE-627 ger DE-627 rakwb eng Balzer, Felix verfasserin (orcid)0000-0003-1575-2056 aut Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2016 Background Currently there is no ARDS definition or classification system that allows optimal prediction of mortality in ARDS patients. This study aimed to examine the predictive values of the AECC and Berlin definitions, as well as clinical and respiratory parameters obtained at onset of ARDS and in the course of the first seven consecutive days. Methods The observational study was conducted at a 14-bed intensive care unit specialized on treatment of ARDS. Predictive validity of the AECC and Berlin definitions as well as $ P_{a} %$ O_{2} $/$ F_{i} %$ O_{2} $ and $ F_{i} %$ O_{2} $/$ P_{a} %$ O_{2} $*$ P_{mean} $ (oxygenation index) on mortality of ARDS patients was assessed and statistically compared. Results Four hundred forty two critically-ill patients admitted for ARDS were analysed. Multivariate Cox regression indicated that the oxygenation index was the most accurate parameter for mortality prediction. The third day after ARDS criteria were met at our hospital was found to represent the best compromise between earliness and accuracy of prognosis of mortality regarding the time of assessment. An oxygenation index of 15 or greater was associated with higher mortality, longer length of stay in ICU and hospital and longer duration of mechanical ventilation. In addition, non-survivors had a significantly longer length of stay and duration of mechanical ventilation in referring hospitals before admitted to the national reference centre than survivors. Conclusions The oxygenation index is suggested to be the most suitable parameter to predict mortality in ARDS, preferably assessed on day 3 after admission to a specialized centre. Patients might benefit when transferred to specialized ICU centres as soon as possible for further treatment. Acute respiratory distress syndrome (dpeaa)DE-He213 Pao2/FIO2 ratio (dpeaa)DE-He213 Oxygenation index (dpeaa)DE-He213 Classification (dpeaa)DE-He213 Risk stratification (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Menk, Mario aut Ziegler, Jannis aut Pille, Christian aut Wernecke, Klaus-Dieter aut Spies, Claudia aut Schmidt, Maren aut Weber-Carstens, Steffen aut Deja, Maria aut Enthalten in BMC anesthesiology [S.l.] : BioMed Central, 2001 16(2016), 1 vom: 08. Nov. (DE-627)355422115 (DE-600)2091252-3 1471-2253 nnns volume:16 year:2016 number:1 day:08 month:11 https://dx.doi.org/10.1186/s12871-016-0272-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 08 11
allfieldsGer	10.1186/s12871-016-0272-4 doi (DE-627)SPR027322300 (SPR)s12871-016-0272-4-e DE-627 ger DE-627 rakwb eng Balzer, Felix verfasserin (orcid)0000-0003-1575-2056 aut Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2016 Background Currently there is no ARDS definition or classification system that allows optimal prediction of mortality in ARDS patients. This study aimed to examine the predictive values of the AECC and Berlin definitions, as well as clinical and respiratory parameters obtained at onset of ARDS and in the course of the first seven consecutive days. Methods The observational study was conducted at a 14-bed intensive care unit specialized on treatment of ARDS. Predictive validity of the AECC and Berlin definitions as well as $ P_{a} %$ O_{2} $/$ F_{i} %$ O_{2} $ and $ F_{i} %$ O_{2} $/$ P_{a} %$ O_{2} $*$ P_{mean} $ (oxygenation index) on mortality of ARDS patients was assessed and statistically compared. Results Four hundred forty two critically-ill patients admitted for ARDS were analysed. Multivariate Cox regression indicated that the oxygenation index was the most accurate parameter for mortality prediction. The third day after ARDS criteria were met at our hospital was found to represent the best compromise between earliness and accuracy of prognosis of mortality regarding the time of assessment. An oxygenation index of 15 or greater was associated with higher mortality, longer length of stay in ICU and hospital and longer duration of mechanical ventilation. In addition, non-survivors had a significantly longer length of stay and duration of mechanical ventilation in referring hospitals before admitted to the national reference centre than survivors. Conclusions The oxygenation index is suggested to be the most suitable parameter to predict mortality in ARDS, preferably assessed on day 3 after admission to a specialized centre. Patients might benefit when transferred to specialized ICU centres as soon as possible for further treatment. Acute respiratory distress syndrome (dpeaa)DE-He213 Pao2/FIO2 ratio (dpeaa)DE-He213 Oxygenation index (dpeaa)DE-He213 Classification (dpeaa)DE-He213 Risk stratification (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Menk, Mario aut Ziegler, Jannis aut Pille, Christian aut Wernecke, Klaus-Dieter aut Spies, Claudia aut Schmidt, Maren aut Weber-Carstens, Steffen aut Deja, Maria aut Enthalten in BMC anesthesiology [S.l.] : BioMed Central, 2001 16(2016), 1 vom: 08. Nov. (DE-627)355422115 (DE-600)2091252-3 1471-2253 nnns volume:16 year:2016 number:1 day:08 month:11 https://dx.doi.org/10.1186/s12871-016-0272-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 08 11
allfieldsSound	10.1186/s12871-016-0272-4 doi (DE-627)SPR027322300 (SPR)s12871-016-0272-4-e DE-627 ger DE-627 rakwb eng Balzer, Felix verfasserin (orcid)0000-0003-1575-2056 aut Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study 2016 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s). 2016 Background Currently there is no ARDS definition or classification system that allows optimal prediction of mortality in ARDS patients. This study aimed to examine the predictive values of the AECC and Berlin definitions, as well as clinical and respiratory parameters obtained at onset of ARDS and in the course of the first seven consecutive days. Methods The observational study was conducted at a 14-bed intensive care unit specialized on treatment of ARDS. Predictive validity of the AECC and Berlin definitions as well as $ P_{a} %$ O_{2} $/$ F_{i} %$ O_{2} $ and $ F_{i} %$ O_{2} $/$ P_{a} %$ O_{2} $*$ P_{mean} $ (oxygenation index) on mortality of ARDS patients was assessed and statistically compared. Results Four hundred forty two critically-ill patients admitted for ARDS were analysed. Multivariate Cox regression indicated that the oxygenation index was the most accurate parameter for mortality prediction. The third day after ARDS criteria were met at our hospital was found to represent the best compromise between earliness and accuracy of prognosis of mortality regarding the time of assessment. An oxygenation index of 15 or greater was associated with higher mortality, longer length of stay in ICU and hospital and longer duration of mechanical ventilation. In addition, non-survivors had a significantly longer length of stay and duration of mechanical ventilation in referring hospitals before admitted to the national reference centre than survivors. Conclusions The oxygenation index is suggested to be the most suitable parameter to predict mortality in ARDS, preferably assessed on day 3 after admission to a specialized centre. Patients might benefit when transferred to specialized ICU centres as soon as possible for further treatment. Acute respiratory distress syndrome (dpeaa)DE-He213 Pao2/FIO2 ratio (dpeaa)DE-He213 Oxygenation index (dpeaa)DE-He213 Classification (dpeaa)DE-He213 Risk stratification (dpeaa)DE-He213 Outcome (dpeaa)DE-He213 Menk, Mario aut Ziegler, Jannis aut Pille, Christian aut Wernecke, Klaus-Dieter aut Spies, Claudia aut Schmidt, Maren aut Weber-Carstens, Steffen aut Deja, Maria aut Enthalten in BMC anesthesiology [S.l.] : BioMed Central, 2001 16(2016), 1 vom: 08. Nov. (DE-627)355422115 (DE-600)2091252-3 1471-2253 nnns volume:16 year:2016 number:1 day:08 month:11 https://dx.doi.org/10.1186/s12871-016-0272-4 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2009 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2055 GBV_ILN_2111 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 16 2016 1 08 11
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author	Balzer, Felix
spellingShingle	Balzer, Felix misc Acute respiratory distress syndrome misc Pao2/FIO2 ratio misc Oxygenation index misc Classification misc Risk stratification misc Outcome Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study
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topic_title	Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study Acute respiratory distress syndrome (dpeaa)DE-He213 Pao2/FIO2 ratio (dpeaa)DE-He213 Oxygenation index (dpeaa)DE-He213 Classification (dpeaa)DE-He213 Risk stratification (dpeaa)DE-He213 Outcome (dpeaa)DE-He213
topic	misc Acute respiratory distress syndrome misc Pao2/FIO2 ratio misc Oxygenation index misc Classification misc Risk stratification misc Outcome
topic_unstemmed	misc Acute respiratory distress syndrome misc Pao2/FIO2 ratio misc Oxygenation index misc Classification misc Risk stratification misc Outcome
topic_browse	misc Acute respiratory distress syndrome misc Pao2/FIO2 ratio misc Oxygenation index misc Classification misc Risk stratification misc Outcome
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title	Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study
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title_full	Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study
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title_sort	predictors of survival in critically ill patients with acute respiratory distress syndrome (ards): an observational study
title_auth	Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study
abstract	Background Currently there is no ARDS definition or classification system that allows optimal prediction of mortality in ARDS patients. This study aimed to examine the predictive values of the AECC and Berlin definitions, as well as clinical and respiratory parameters obtained at onset of ARDS and in the course of the first seven consecutive days. Methods The observational study was conducted at a 14-bed intensive care unit specialized on treatment of ARDS. Predictive validity of the AECC and Berlin definitions as well as $ P_{a} %$ O_{2} $/$ F_{i} %$ O_{2} $ and $ F_{i} %$ O_{2} $/$ P_{a} %$ O_{2} $*$ P_{mean} $ (oxygenation index) on mortality of ARDS patients was assessed and statistically compared. Results Four hundred forty two critically-ill patients admitted for ARDS were analysed. Multivariate Cox regression indicated that the oxygenation index was the most accurate parameter for mortality prediction. The third day after ARDS criteria were met at our hospital was found to represent the best compromise between earliness and accuracy of prognosis of mortality regarding the time of assessment. An oxygenation index of 15 or greater was associated with higher mortality, longer length of stay in ICU and hospital and longer duration of mechanical ventilation. In addition, non-survivors had a significantly longer length of stay and duration of mechanical ventilation in referring hospitals before admitted to the national reference centre than survivors. Conclusions The oxygenation index is suggested to be the most suitable parameter to predict mortality in ARDS, preferably assessed on day 3 after admission to a specialized centre. Patients might benefit when transferred to specialized ICU centres as soon as possible for further treatment. © The Author(s). 2016
abstractGer	Background Currently there is no ARDS definition or classification system that allows optimal prediction of mortality in ARDS patients. This study aimed to examine the predictive values of the AECC and Berlin definitions, as well as clinical and respiratory parameters obtained at onset of ARDS and in the course of the first seven consecutive days. Methods The observational study was conducted at a 14-bed intensive care unit specialized on treatment of ARDS. Predictive validity of the AECC and Berlin definitions as well as $ P_{a} %$ O_{2} $/$ F_{i} %$ O_{2} $ and $ F_{i} %$ O_{2} $/$ P_{a} %$ O_{2} $*$ P_{mean} $ (oxygenation index) on mortality of ARDS patients was assessed and statistically compared. Results Four hundred forty two critically-ill patients admitted for ARDS were analysed. Multivariate Cox regression indicated that the oxygenation index was the most accurate parameter for mortality prediction. The third day after ARDS criteria were met at our hospital was found to represent the best compromise between earliness and accuracy of prognosis of mortality regarding the time of assessment. An oxygenation index of 15 or greater was associated with higher mortality, longer length of stay in ICU and hospital and longer duration of mechanical ventilation. In addition, non-survivors had a significantly longer length of stay and duration of mechanical ventilation in referring hospitals before admitted to the national reference centre than survivors. Conclusions The oxygenation index is suggested to be the most suitable parameter to predict mortality in ARDS, preferably assessed on day 3 after admission to a specialized centre. Patients might benefit when transferred to specialized ICU centres as soon as possible for further treatment. © The Author(s). 2016
abstract_unstemmed	Background Currently there is no ARDS definition or classification system that allows optimal prediction of mortality in ARDS patients. This study aimed to examine the predictive values of the AECC and Berlin definitions, as well as clinical and respiratory parameters obtained at onset of ARDS and in the course of the first seven consecutive days. Methods The observational study was conducted at a 14-bed intensive care unit specialized on treatment of ARDS. Predictive validity of the AECC and Berlin definitions as well as $ P_{a} %$ O_{2} $/$ F_{i} %$ O_{2} $ and $ F_{i} %$ O_{2} $/$ P_{a} %$ O_{2} $*$ P_{mean} $ (oxygenation index) on mortality of ARDS patients was assessed and statistically compared. Results Four hundred forty two critically-ill patients admitted for ARDS were analysed. Multivariate Cox regression indicated that the oxygenation index was the most accurate parameter for mortality prediction. The third day after ARDS criteria were met at our hospital was found to represent the best compromise between earliness and accuracy of prognosis of mortality regarding the time of assessment. An oxygenation index of 15 or greater was associated with higher mortality, longer length of stay in ICU and hospital and longer duration of mechanical ventilation. In addition, non-survivors had a significantly longer length of stay and duration of mechanical ventilation in referring hospitals before admitted to the national reference centre than survivors. Conclusions The oxygenation index is suggested to be the most suitable parameter to predict mortality in ARDS, preferably assessed on day 3 after admission to a specialized centre. Patients might benefit when transferred to specialized ICU centres as soon as possible for further treatment. © The Author(s). 2016
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title_short	Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study
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This study aimed to examine the predictive values of the AECC and Berlin definitions, as well as clinical and respiratory parameters obtained at onset of ARDS and in the course of the first seven consecutive days. Methods The observational study was conducted at a 14-bed intensive care unit specialized on treatment of ARDS. Predictive validity of the AECC and Berlin definitions as well as $ P_{a} %$ O_{2} $/$ F_{i} %$ O_{2} $ and $ F_{i} %$ O_{2} $/$ P_{a} %$ O_{2} $*$ P_{mean} $ (oxygenation index) on mortality of ARDS patients was assessed and statistically compared. Results Four hundred forty two critically-ill patients admitted for ARDS were analysed. Multivariate Cox regression indicated that the oxygenation index was the most accurate parameter for mortality prediction. The third day after ARDS criteria were met at our hospital was found to represent the best compromise between earliness and accuracy of prognosis of mortality regarding the time of assessment. An oxygenation index of 15 or greater was associated with higher mortality, longer length of stay in ICU and hospital and longer duration of mechanical ventilation. In addition, non-survivors had a significantly longer length of stay and duration of mechanical ventilation in referring hospitals before admitted to the national reference centre than survivors. Conclusions The oxygenation index is suggested to be the most suitable parameter to predict mortality in ARDS, preferably assessed on day 3 after admission to a specialized centre. 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Predictors of survival in critically ill patients with acute respiratory distress syndrome (ARDS): an observational study

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