Derivation and validation of Spo2/FIo2 ratio to impute for Pao2/FIo2 ratio in the respiratory component of the Sequential Organ Failure Assessment score
Derivation and validation of Spo2/FIo2 ratio to impute for Pao2/FIo2 ratio in the respiratory component of the Sequential Organ Failure Assessment score
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DOI：
10.1097/ccm.0b013e31819cefa9
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发表时间：
2009-04-01
影响因子：
8.8
通讯作者：
Ely, E. Wesley
中科院分区：
文献类型：
--
作者：
Pandharipande, Pratik P.;Shintani, Ayumi K.;Ely, E. Wesley
目标。序贯器官衰竭评估(SOFA)评分用于衡量危重患者器官功能障碍的严重程度。然而，在一些练习环境中，计算SOFA评分的呼吸成分所需的每日动脉血气数据往往不可用。本研究的目的是推导Spo(2)/FiO2(SF)比率与PaO(2)/FiO2(PF)比率的相关性，以计算SOFA评分的呼吸参数，并根据临床结果验证使用SF比率获得的呼吸SOFA。患者和测量：我们从两个人群获得匹配的Spo(2)和PaO(2)测量：组I-全麻患者和组2-来自急性呼吸窘迫综合征网络的患者-低与低。高潮量为急性呼吸管理急性呼吸窘迫综合征数据库。使用线性回归模型，我们首先确定对应于PF比率100、200、300和400的SF比率。其次，我们评估了呼气末正压(PEEP)对SF和PF之间关系的贡献，对于PEEP为12厘米的水(Cm H2O)的患者，第三，我们使用导出的SF比率计算了重症监护病房患者的SOFA评分，并与临床结果进行了验证。根据SF比和PF比计算的SOFA总分在所有患者中高度相关(Spearman‘s Rho0.85，P<；0.001)，在三个分层PEEP类别中(12 cm H2O，Spearman’s Rho0.85，P<；0.001)。基于SF比率和PF比率的呼吸SOFA评分与重症监护病房住院时间和无呼吸机天数的相关性相似，在一组危重患者中得到验证。结论：根据SF值得出的总分和呼吸SOFA评分与使用PF比率的相应SOFA评分相关。得出的和原始的呼吸沙发评分都可以预测结果。(危重护理模式2009；37：1317-1321)
Objective. The Sequential Organ Failure Assessment (SOFA) score is validated to measure severity of organ dysfunction in critically ill patients. However, In some practice settings, daily arterial blood gas data required to calculate the respiratory component of the SOFA score are often unavailable. The objectives of this study were to derive Spo(2)/FIO2 (SF) ratio correlations with the Pao(2)/FIO2 (PF) ratio to calculate the respiratory parameter of the SOFA score, and to validate the respiratory SOFA obtained using SF ratios against clinical outcomes.Patients and Measurements: We obtained matched measurements Of Spo(2) and Pao(2) from two populations: group I-patients undergoing general anesthesia and group 2-patients from the acute respiratory distress syndrome network-low-vs. high-tidal volume for the acute respiratory management of acute respiratory distress syndrome database. Using a linear regression model, we first determined SF ratios corresponding to PF ratios of 100, 200, 300, and 400. Second, we evaluated the contribution of positive end-expiratory pressure (PEEP) on the relationship between SF and PF, for patients on PEEP in centimeters of water (cm H2O) Of 12, Third, we calculated the SOFA scores in a separate cohort of intensive care unit patients using the derived SF ratios and validated them against clinical outcomes.Results. The total SOFA scores calculated using SF ratios and PF ratios were highly correlated (Spearman's rho 0.85, p < 0.001) in all patients and in the three stratified PEEP categories (12 cm H2O, Spearman's rho 0.85, p < 0.001). The respiratory SOFA scores based on SF ratios and PF ratios correlated similarly with intensive care unit length of stay and ventilator-free days, when validated in a cohort of critically ill patients.Conclusion: The total and respiratory SOFA scores obtained with imputed SF values correlate with the corresponding SOFA score using PF ratios. Both the derived and original respiratory SOFA scores similarly predict outcomes. (Crit Care Mod 2009; 37: 1317-1321)