Diagnostics (Dec 2023)

Categorizing Acute Respiratory Distress Syndrome with Different Severities by Oxygen Saturation Index

  • Shin-Hwar Wu,
  • Chew-Teng Kor,
  • Shu-Hua Chi,
  • Chun-Yu Li

DOI
https://doi.org/10.3390/diagnostics14010037
Journal volume & issue
Vol. 14, no. 1
p. 37

Abstract

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The oxygen saturation index (OSI), defined by FIO2/SpO2 multiplied by the mean airway pressure, has been reported to exceed the Berlin definition in predicting the mortality of acute respiratory distress syndrome (ARDS). The OSI has served as an alternative to the Berlin definition in categorizing pediatric ARDS. However, the use of the OSI for the stratification of adult ARDS has not been reported. A total of 379 invasively ventilated adult ARDS patients were retrospectively studied. The ARDS patients were classified into three groups by their incidence rate of mortality: mild (OSI 23.08). OSI-based categorization was highly correlated with the Berlin definition by a Kendall’s tau of 0.578 (p p < 0.001). By the Berlin definition, the hazard ratio for 28-day mortality was 0.58 (0.33–1.05) and 0.95 (0.55–1.67) for the moderate and severe groups, respectively (compared to the mild group). In contrast, the corresponding hazard ratio was 1.01 (0.69–1.47) and 2.39 (1.71–3.35) for the moderate and severe groups defined by the OSI. By multivariate analysis, OSI-based severe ARDS was independently associated with 28-D or 90-D mortality. In conclusion, we report the first OSI-based stratification for adult ARDS and find that it serves well as an alternative to the Berlin definition.

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