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Predictive Role of Lung Injury Prediction Score in the Development of Acute Respiratory Distress Syndrome in Korea

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초록

Purpose: Early recognition and therapeutic intervention are important in patients at high risk of acute respiratory distress syndrome(ARDS). The lung injury prediction score (LIPS) has been used to predict ARDS development; however, it was developedbased on the previous definition of ARDS. We investigated the predictive role of LIPS in ARDS development according to its Berlindefinition in the Korean population. Materials and Methods: This was a retrospective study that enrolled adult patients admitted to the intensive care unit (ICU) at asingle university-affiliated hospital in Korea from September 1, 2018, to August 31, 2019. LIPS at the time of ICU admission andthe development of ARDS were evaluated. Results: Of the 548 enrolled patients, 33 (6.0%) fulfilled the Berlin ARDS definition. The LIPS for non-ARDS and ARDS groupswere 4.96±3.05 and 8.53±2.45, respectively (p<0.001); it was significantly associated with ARDS development (odds ratio 1.48, 95%confidence interval, 1.29–1.69; p<0.001). LIPS >6 predicted the development of ARDS with a sensitivity of 84.8% and a specificityof 67.2% [area under the curve (AUC)=0.82]. A modified LIPS model adjusted for age and severity at ICU admission predicted ICUmortality in patients with ARDS (AUC=0.80), but not in those without ARDS (AUC=0.54). Conclusion: LIPS predicted the development of ARDS as diagnosed by the Berlin definition in the Korean population. LIPS providesuseful information for managing patients with ARDS.

Abstract

Purpose: Early recognition and therapeutic intervention are important in patients at high risk of acute respiratory distress syndrome(ARDS). The lung injury prediction score (LIPS) has been used to predict ARDS development; however, it was developedbased on the previous definition of ARDS. We investigated the predictive role of LIPS in ARDS development according to its Berlindefinition in the Korean population. Materials and Methods: This was a retrospective study that enrolled adult patients admitted to the intensive care unit (ICU) at asingle university-affiliated hospital in Korea from September 1, 2018, to August 31, 2019. LIPS at the time of ICU admission andthe development of ARDS were evaluated. Results: Of the 548 enrolled patients, 33 (6.0%) fulfilled the Berlin ARDS definition. The LIPS for non-ARDS and ARDS groupswere 4.96±3.05 and 8.53±2.45, respectively (p<0.001); it was significantly associated with ARDS development (odds ratio 1.48, 95%confidence interval, 1.29–1.69; p<0.001). LIPS >6 predicted the development of ARDS with a sensitivity of 84.8% and a specificityof 67.2% [area under the curve (AUC)=0.82]. A modified LIPS model adjusted for age and severity at ICU admission predicted ICUmortality in patients with ARDS (AUC=0.80), but not in those without ARDS (AUC=0.54). Conclusion: LIPS predicted the development of ARDS as diagnosed by the Berlin definition in the Korean population. LIPS providesuseful information for managing patients with ARDS.

참고문헌 (20)

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