Validity of Outcome Prediction Scoring Systems in Korean Patients with Severe Adult Respiratory Distress Syndrome Receiving Extracorporeal Membrane Oxygenation Therapy.
10.3346/jkms.2016.31.6.932
- Author:
Seunghyun LEE
1
;
Hye Ju YEO
;
Seong Hoon YOON
;
Seung Eun LEE
;
Woo Hyun CHO
;
Doo Soo JEON
;
Yun Seong KIM
;
Bong Soo SON
;
Do Hyung KIM
Author Information
1. Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea. popeyes0212@hanmail.net
- Publication Type:Original Article ; Validation Studies
- Keywords:
Extracorporeal Membrane Oxygenation;
Respiratory Distress Syndrome;
Adult;
Intensive Care;
Outcome Assessment
- MeSH:
Adult;
Aged;
Area Under Curve;
*Extracorporeal Membrane Oxygenation/classification;
Female;
Humans;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Prognosis;
ROC Curve;
Republic of Korea;
Research Design/*standards;
Respiratory Distress Syndrome, Adult/mortality/pathology/*therapy;
Retrospective Studies;
Severity of Illness Index
- From:Journal of Korean Medical Science
2016;31(6):932-938
- CountryRepublic of Korea
- Language:English
-
Abstract:
Recently, several prognostic scoring systems for patients with severe acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO) have been published. The aim of this study was to validate the established scoring systems for outcome prediction in Korean patients. We retrospectively reviewed the data of 50 patients on ECMO therapy in our center from 2012 to 2014. A calculation of outcome prediction scoring tools was performed and the comparison across various models was conducted. In our study, the overall hospital survival was 46% and successful weaning rate was 58%. The Predicting Death for Severe ARDS on V-V ECMO (PRESERVE) score showed good discrimination of mortality prediction for patients on ECMO with AUC of 0.80 (95% CI 0.66-0.90). The respiratory extracorporeal membrane oxygenation survival prediction (RESP) score and simplified acute physiology score (SAPS) II score also showed fair prediction ability with AUC of 0.79 (95% CI 0.65-0.89) and AUC of 0.78 (95% CI 0.64-0.88), respectively. However, the ECMOnet score failed to predict mortality with AUC of 0.51 (95% CI 0.37-0.66). When evaluating the predictive accuracy according to optimal cut-off point of each scoring system, RESP score had a best specificity of 91.3% and 66.7% of sensitivity, respectively. This study supports the clinical usefulness of the prognostic scoring tools for severe ARDS with ECMO therapy when applying to the Korean patients receiving ECMO.
