Role of SpO2/FiO2 Ratio and ROX Index in Predicting Early Invasive Mechanical Ventilation in COVID-19. A Pragmatic, Retrospective, Multi-Center Study

The ability of COVID-19 to compromise the respiratory system has generated a substantial proportion of critically ill patients in need of invasive mechanical ventilation (IMV). The objective of this paper was to analyze the prognostic ability of the pulse oximetry saturation/fraction of inspired oxy...

Full description

Saved in:
Bibliographic Details
Published in:Biomedicines 2021-08, Vol.9 (8), p.1036
Main Authors: Alberdi-Iglesias, Ana, Martín-Rodríguez, Francisco, Ortega Rabbione, Guillermo, Rubio-Babiano, Ana I, Núñez-Toste, María G, Sanz-García, Ancor, Del Pozo Vegas, Carlos, Castro Villamor, Miguel A, Martín-Conty, José L, Jorge-Soto, Cristina, López-Izquierdo, Raúl
Format: Article
Language:English
Subjects:
Age
clinical decision making
Coronaviruses
COVID-19
emergency care
Emergency medical care
Emergency services
Heart rate
Hospitals
hypoxemia
Intensive care
Intubation
Mechanical ventilation
Medical records
Mortality
Normal distribution
Nursing homes
Oxygen saturation
Pandemics
Patients
Prediction models
Pulse oximetry
Respiration
Respiratory system
risk scores
Severe acute respiratory syndrome coronavirus 2
Ventilators
Vital signs
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The ability of COVID-19 to compromise the respiratory system has generated a substantial proportion of critically ill patients in need of invasive mechanical ventilation (IMV). The objective of this paper was to analyze the prognostic ability of the pulse oximetry saturation/fraction of inspired oxygen ratio (SpO2/FiO2) and the ratio of SpO2/FiO2 to the respiratory rate-ROX index-as predictors of IMV in an emergency department in confirmed COVID-19 patients. A multicenter, retrospective cohort study was carried out in four provinces of Spain between March and November 2020. The discriminative power of the predictive variable was assessed through a prediction model trained using a derivation sub-cohort and evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) on the validation sub-cohort. A total of 2040 patients were included in the study. The IMV rate was 10.1%, with an in-hospital mortality rate of 35.3%. The performance of the SpO2/FiO2 ratio was better than the ROX index-AUC = 0.801 (95% CI 0.746-0.855) and AUC = 0.725 (95% CI 0.652-0.798), respectively. In fact, a direct comparison between AUCs resulted in significant differences ( = 0.001). SpO2 to FiO2 ratio is a simple and promising non-invasive tool for predicting risk of IMV in patients infected with COVID-19, and it is realizable in emergency departments.
ISSN:2227-9059
2227-9059
DOI:10.3390/biomedicines9081036