Developing prevention model of acute lung injury: Validity of lung injury prediction score and risk panel

Abstract

Background: Acute lung injury (ALI) is an example of a critical care syndrome with few therapeutic modalities once the syndrome is fully established, and little has been done on the prevention of ALI. Aim of the work: The aim of this work was to early identify the onset of acute lung injury (ALI) on admission and to prospectively evaluate the lung injury prediction score (LIPS). Patients and methods: The study was carried out on 100 patients who aged >18 years, patients who had one or more of the acute lung injury (ALI) predisposing conditions on admission or within 6 h after were subjected to lung injury prediction score (LIPS). Results: Acute lung injury developed in 15 patients, 11 patients (73.3%) had LIPS >3, while 4 patients (26.7%) had LIPS ⩽3 and only 4.70% of those who didn’t develop ALI had LIPS >3, with a statistically significant relationship between patients above and below LIPS value of 3 (P = 0.000), LIPS cutoff value of ⩾3.5 on admission had a 73% sensitivity and 95% specificity with an area under the receiver operating curve of 0.883 (95% CI 0.782 to 0.984). Sepsis and pneumonia were the most frequent risk factors (60%). Conclusions: Lung injury predictive score (LIPS) could early predict patients at risk to develop ALI on admission, Hyperbilirubinemia, high blood urea level and abnormal chest X-ray on admission were not included in the original LIPS but had significant association with development of ALI.

Keywords

• Acute lung injury
• Lung injury prediction score
• CRP