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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8392288/
https://www.ncbi.nlm.nih.gov/pubmed/34440240
http://dx.doi.org/10.3390/biomedicines9081036
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author 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
author_facet 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
author_sort Alberdi-Iglesias, Ana
collection PubMed
description 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 (p = 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.
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spelling pubmed-83922882021-08-28 Role of SpO2/FiO2 Ratio and ROX Index in Predicting Early Invasive Mechanical Ventilation in COVID-19. A Pragmatic, Retrospective, Multi-Center Study 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 Biomedicines Article 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 (p = 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. MDPI 2021-08-18 /pmc/articles/PMC8392288/ /pubmed/34440240 http://dx.doi.org/10.3390/biomedicines9081036 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
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
Role of SpO2/FiO2 Ratio and ROX Index in Predicting Early Invasive Mechanical Ventilation in COVID-19. A Pragmatic, Retrospective, Multi-Center Study
title Role of SpO2/FiO2 Ratio and ROX Index in Predicting Early Invasive Mechanical Ventilation in COVID-19. A Pragmatic, Retrospective, Multi-Center Study
title_full Role of SpO2/FiO2 Ratio and ROX Index in Predicting Early Invasive Mechanical Ventilation in COVID-19. A Pragmatic, Retrospective, Multi-Center Study
title_fullStr Role of SpO2/FiO2 Ratio and ROX Index in Predicting Early Invasive Mechanical Ventilation in COVID-19. A Pragmatic, Retrospective, Multi-Center Study
title_full_unstemmed Role of SpO2/FiO2 Ratio and ROX Index in Predicting Early Invasive Mechanical Ventilation in COVID-19. A Pragmatic, Retrospective, Multi-Center Study
title_short Role of SpO2/FiO2 Ratio and ROX Index in Predicting Early Invasive Mechanical Ventilation in COVID-19. A Pragmatic, Retrospective, Multi-Center Study
title_sort role of spo2/fio2 ratio and rox index in predicting early invasive mechanical ventilation in covid-19. a pragmatic, retrospective, multi-center study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8392288/
https://www.ncbi.nlm.nih.gov/pubmed/34440240
http://dx.doi.org/10.3390/biomedicines9081036
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