title: Validity of Outcome Prediction Scoring Systems in Korean Patients with Severe Adult Respiratory Distress Syndrome Receiving Extracorporeal Membrane Oxygenation Therapy.
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.
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea .
authors.forename: Seunghyun
authors.identifier: 0000-0003-0654-8344
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea .
authors.forename: Hye Ju
authors.identifier: 0000-0002-8403-5790
authors.initials: HJ
authors.lastname: Yeo
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea .
authors.forename: Seong Hoon
authors.identifier: 0000-0002-2075-4702
authors.initials: SH
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea .
authors.forename: Seung Eun
authors.identifier: 0000-0002-4266-7722
authors.initials: SE
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea .
authors.forename: Woo Hyun
authors.identifier: 0000-0002-8299-8008
authors.initials: WH
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea .
authors.forename: Doo Soo
authors.identifier: 0000-0002-8206-9487
authors.initials: DS
authors.lastname: Jeon
authors.affiliation: Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea .
authors.forename: Yun Seong
authors.identifier: 0000-0003-4328-0818
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea .
authors.forename: Bong Soo
authors.identifier: 0000-0001-6681-6094
authors.initials: BS
authors.lastname: Son
authors.affiliation: Department of Cardiovascular and Thoracic Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea .
authors.forename: Do Hyung
authors.identifier: 0000-0002-8774-3397
authors.initials: do H
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D015199:Extracorporeal Membrane Oxygenation / Q000145:classification; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D056910:Republic of Korea; D012107:Research Design / Q000592:standards*; D012128:Respiratory Distress Syndrome / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Adult; Extracorporeal Membrane Oxygenation; Intensive Care; Outcome Assessment; Respiratory Distress Syndrome