Evaluation of the oxygenation index in adult respiratory failure.
BACKGROUND
The oxygenation index (mean airway pressure × FIO2 divided by PaO2) was originally devised to measure severity of illness and predict outcome in neonatal respiratory failure. We evaluated the discrimination of a modified oxygenation index (modified with age) for predicting 28-day mortality in adults with respiratory failure (adult respiratory distress syndrome [ARDS]) using the ALVEOLI section of the ARDSNet database and validated the results in the full ARDSNet database.


METHODS
We compared age-adjusted oxygenation index (AOI) on ventilator Days 1 to 4 with 28-day mortality.


RESULTS
AOI correlated positively with mortality (area under the receiver operating characteristic curve, 0.70-0.74, for ARDS Days 1-4). Following initial development, AOI related to mortality was validated in two other ARDSNet databases producing similar results (area under the receiver operating characteristic curve, 0.70-0.78).


CONCLUSIONS
The observed sensitivity and specificity analysis demonstrated that AOI is equivalent to or better than other mortality prediction systems used for ARDS.


METHODS
Prognostic, level III.
From the Departments of Surgery, University of Michigan, Ann Arbor, Michigan.
Ronald E
RE
Dechert
Pauline K
PK
Park
Robert H
RH
Bartlett
D000328:Adult; D001784:Blood Gas Analysis / Q000379:methods; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010092:Oximetry / Q000379:methods; D010100:Oxygen / Q000097:blood*; D010101:Oxygen Consumption / Q000502:physiology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012121:Respiration, Artificial / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
D010100:Oxygen