Prognostic performance of the Age, PaO/FiO Ratio, and Plateau Pressure Score (APPS) for mortality in patients with COVID-19-associated acute respiratory distress syndrome admitted to an intensive care unit

Background: A predictive scoring system used in patients with acute respiratory distress syndrome (ARDS) known as Age, PaO 2 /FiO 2 , Plateau Pressure Score (APPS) has been externally validated to predict mortality in Asian and Caucasian populations. Its performance in Latin American and COVID-19 pa...

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Main Authors: Alfredo A. M. Gutierrez-Zamudio, Rodrigo Alejandro-Salinas, Jose I. Vereau-Robles, Carlos J. Toro-Huamanchumo
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:Therapeutic Advances in Infectious Disease
Online Access:https://doi.org/10.1177/20499361241306212
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author Alfredo A. M. Gutierrez-Zamudio
Rodrigo Alejandro-Salinas
Jose I. Vereau-Robles
Carlos J. Toro-Huamanchumo
author_facet Alfredo A. M. Gutierrez-Zamudio
Rodrigo Alejandro-Salinas
Jose I. Vereau-Robles
Carlos J. Toro-Huamanchumo
author_sort Alfredo A. M. Gutierrez-Zamudio
collection DOAJ
description Background: A predictive scoring system used in patients with acute respiratory distress syndrome (ARDS) known as Age, PaO 2 /FiO 2 , Plateau Pressure Score (APPS) has been externally validated to predict mortality in Asian and Caucasian populations. Its performance in Latin American and COVID-19 patients still needs to be done. Objective: To assess the association between APPS and mortality, as well as APPS performance in predicting mortality within 28 days of intensive care unit (ICU) admission in patients with ARDS due to COVID-19. Design: Analytical observational retrospective cohort study. Methods: We conducted a retrospective cohort study in patients diagnosed with ARDS according to the Berlin criteria who were admitted to the ICU. We evaluated the prognostic performance of APPS using the area under the receiver operating characteristic curve (AUC-ROC), and association with mortality was measured using the Cox proportional hazards regression models. Results: A total of 271 patients were analyzed. The AUC for 28-day mortality was 0.78 (95% CI: 0.73–0.84). In the Cox proportional hazards model, after adjusting for sex and categorized Charlson Comorbidity Index, it was found that grade 2 APPS (aHR: 3.67, 95% CI: 2.14–6.30, p  < 0.001) and grade 3 APPS (aHR: 7.95, 95% CI: 3.72–17.02, p  < 0.001) were associated with a higher hazard of 28-day mortality. Conclusion: The APPS scoring system has a good prognostic performance for mortality in patients diagnosed with COVID-19-induced ARDS.
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spelling doaj-art-68310776237a4cc4942a6905ab3588302025-08-20T02:38:43ZengSAGE PublishingTherapeutic Advances in Infectious Disease2049-937X2024-12-011110.1177/20499361241306212Prognostic performance of the Age, PaO/FiO Ratio, and Plateau Pressure Score (APPS) for mortality in patients with COVID-19-associated acute respiratory distress syndrome admitted to an intensive care unitAlfredo A. M. Gutierrez-ZamudioRodrigo Alejandro-SalinasJose I. Vereau-RoblesCarlos J. Toro-HuamanchumoBackground: A predictive scoring system used in patients with acute respiratory distress syndrome (ARDS) known as Age, PaO 2 /FiO 2 , Plateau Pressure Score (APPS) has been externally validated to predict mortality in Asian and Caucasian populations. Its performance in Latin American and COVID-19 patients still needs to be done. Objective: To assess the association between APPS and mortality, as well as APPS performance in predicting mortality within 28 days of intensive care unit (ICU) admission in patients with ARDS due to COVID-19. Design: Analytical observational retrospective cohort study. Methods: We conducted a retrospective cohort study in patients diagnosed with ARDS according to the Berlin criteria who were admitted to the ICU. We evaluated the prognostic performance of APPS using the area under the receiver operating characteristic curve (AUC-ROC), and association with mortality was measured using the Cox proportional hazards regression models. Results: A total of 271 patients were analyzed. The AUC for 28-day mortality was 0.78 (95% CI: 0.73–0.84). In the Cox proportional hazards model, after adjusting for sex and categorized Charlson Comorbidity Index, it was found that grade 2 APPS (aHR: 3.67, 95% CI: 2.14–6.30, p  < 0.001) and grade 3 APPS (aHR: 7.95, 95% CI: 3.72–17.02, p  < 0.001) were associated with a higher hazard of 28-day mortality. Conclusion: The APPS scoring system has a good prognostic performance for mortality in patients diagnosed with COVID-19-induced ARDS.https://doi.org/10.1177/20499361241306212
spellingShingle Alfredo A. M. Gutierrez-Zamudio
Rodrigo Alejandro-Salinas
Jose I. Vereau-Robles
Carlos J. Toro-Huamanchumo
Prognostic performance of the Age, PaO/FiO Ratio, and Plateau Pressure Score (APPS) for mortality in patients with COVID-19-associated acute respiratory distress syndrome admitted to an intensive care unit
Therapeutic Advances in Infectious Disease
title Prognostic performance of the Age, PaO/FiO Ratio, and Plateau Pressure Score (APPS) for mortality in patients with COVID-19-associated acute respiratory distress syndrome admitted to an intensive care unit
title_full Prognostic performance of the Age, PaO/FiO Ratio, and Plateau Pressure Score (APPS) for mortality in patients with COVID-19-associated acute respiratory distress syndrome admitted to an intensive care unit
title_fullStr Prognostic performance of the Age, PaO/FiO Ratio, and Plateau Pressure Score (APPS) for mortality in patients with COVID-19-associated acute respiratory distress syndrome admitted to an intensive care unit
title_full_unstemmed Prognostic performance of the Age, PaO/FiO Ratio, and Plateau Pressure Score (APPS) for mortality in patients with COVID-19-associated acute respiratory distress syndrome admitted to an intensive care unit
title_short Prognostic performance of the Age, PaO/FiO Ratio, and Plateau Pressure Score (APPS) for mortality in patients with COVID-19-associated acute respiratory distress syndrome admitted to an intensive care unit
title_sort prognostic performance of the age pao fio ratio and plateau pressure score apps for mortality in patients with covid 19 associated acute respiratory distress syndrome admitted to an intensive care unit
url https://doi.org/10.1177/20499361241306212
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