External Validation of the PREdiction of Survival on Extracorporeal Membrane Oxygenation Therapy (PRESET) Score: A Single-Center Cohort Experience.

IF 3.1 3区 医学 Q2 ENGINEERING, BIOMEDICAL
ASAIO Journal Pub Date : 2024-11-01 Epub Date: 2024-05-10 DOI:10.1097/MAT.0000000000002226
Vitalie Mazuru, Sebastian Mang, Jonas Ajouri, Ralf M Muellenbach, Robert Bals, Maximilian Feth, Carsten Zeiner, Tobias Wengenmayer, Philipp M Lepper, Torben M Rixecker, Frederik Seiler
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引用次数: 0

Abstract

Acute respiratory distress syndrome (ARDS) is a life-threatening condition affecting >10% of intensive care unit (ICU) patients worldwide with a mortality of up to 59% depending on severity. Extracorporeal membrane oxygenation (ECMO) is a potentially life-saving procedure in severe ARDS but is technically and financially challenging. In recent years, various scoring systems have been proposed to select patients most likely to benefit from ECMO, with the PREdiction of Survival on ECMO Therapy (PRESET) score being one of the most used. We collected data from 283 patients with ARDS of various etiology who underwent veno-venous (V-V) ECMO therapy at a German tertiary care ICU from January 2012 to December 2022. Median age in the cohort was 56 years, and 64.31% were males. The in-hospital mortality rate was 50.88% (n = 144). The median (25%; 75% quartile) severity scores were 38 (31; 49) for Simplified Acute Physiology Score (SAPS) II, 12 (10; 13) for Sequential Organ Failure Assessment (SOFA) and 7 (5; 8) for PRESET. Simplified Acute Physiology Score-II displayed the best prognostic value (area under the receiver operating characteristic [AUROC]: 0.665 [confidence interval (CI): 0.574-0.756; p = 0.046]). Prediction performance was weak in all analyzed scores despite good calibration. Simplified Acute Physiology Score-II had the best discrimination after adjustment of our original cohort. The use of scores explored in this study for patient selection for eligibility for V-V ECMO is not recommendable.

体外膜氧合疗法存活率预测(PRESET)评分的外部验证:单中心队列经验。
急性呼吸窘迫综合征(ARDS)是一种危及生命的疾病,全球有超过 10% 的重症监护病房(ICU)患者会受到影响,死亡率高达 59%,具体取决于病情的严重程度。体外膜肺氧合(ECMO)是严重 ARDS 的潜在救命方法,但在技术和经济上都具有挑战性。近年来,人们提出了各种评分系统来选择最有可能从 ECMO 中获益的患者,其中最常用的是 ECMO 治疗存活率预测评分(PRESET)。我们收集了 2012 年 1 月至 2022 年 12 月期间在德国一家三级重症监护病房接受静脉-静脉 (V-V) ECMO 治疗的 283 名不同病因的 ARDS 患者的数据。组群的中位年龄为 56 岁,64.31% 为男性。院内死亡率为 50.88%(n = 144)。简化急性生理学评分(SAPS)II的严重程度评分中位数(25%;75%四分位数)为38(31;49),序贯器官衰竭评估(SOFA)为12(10;13),PRESET为7(5;8)。简化急性生理学评分 II 显示出最佳的预后价值(接收者操作特征下面积 [AUROC]:0.665 [置信区间 (0.9)]):0.665[置信区间 (CI):0.574-0.756;P = 0.046])。尽管校准结果良好,但所有分析评分的预测性能均较弱。在对我们的原始队列进行调整后,简化急性生理学评分-II 的区分度最高。不建议使用本研究中探讨的评分来选择符合 V-V ECMO 条件的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
ASAIO Journal
ASAIO Journal 医学-工程:生物医学
CiteScore
6.60
自引率
7.10%
发文量
651
审稿时长
4-8 weeks
期刊介绍: ASAIO Journal is in the forefront of artificial organ research and development. On the cutting edge of innovative technology, it features peer-reviewed articles of the highest quality that describe research, development, the most recent advances in the design of artificial organ devices and findings from initial testing. Bimonthly, the ASAIO Journal features state-of-the-art investigations, laboratory and clinical trials, and discussions and opinions from experts around the world. The official publication of the American Society for Artificial Internal Organs.
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