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Research ArticleOriginal Research

Prognostic Value of the Intensive Care Respiratory Distress Observation Scale on ICU Admission

Maxens Decavèle, Isabelle Rivals, Romain Persichini, Julien Mayaux, Laure Serresse, Capucine Morélot-Panzini, Martin Dres, Alexandre Demoule and Thomas Similowski
Respiratory Care April 2022, respcare.09601; DOI: https://doi.org/10.4187/respcare.09601
Maxens Decavèle
Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale Clinique, F-75005 Paris, France; and Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service Médecine Intensive et Réanimation (Département R3S), F-75013 Paris, France.
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  • For correspondence: [email protected]
Isabelle Rivals
Equipe de Statistique Appliquée, ESPCI Paris, PSL Research University, Paris, France.
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Romain Persichini
Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service Médecine Intensive et Réanimation (Département R3S), F-75013 Paris, France.
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Julien Mayaux
Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service Médecine Intensive et Réanimation (Département R3S), F-75013 Paris, France.
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Laure Serresse
Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; and Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Unité Mobile d'Accompagnement et de Soins Palliatifs, Paris, France.
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Capucine Morélot-Panzini
Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; and Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Pneumologie (Département R3S), F-75013 Paris, France.
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Martin Dres
Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale Clinique, F-75005 Paris, France; and Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service Médecine Intensive et Réanimation (Département R3S), F-75013 Paris, France.
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Alexandre Demoule
Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale Clinique, F-75005 Paris, France; and Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service Médecine Intensive et Réanimation (Département R3S), F-75013 Paris, France.
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Thomas Similowski
Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; and Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Département R3S, F-75013 Paris, France.
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Abstract

BACKGROUND: The association between dyspnea and mortality has not been demonstrated in the ICU setting. We tested the hypothesis that dyspnea (self-reported respiratory discomfort) or its observational correlates (5-item intensive care Respiratory Distress Observation Scale [IC-RDOS]) assessed on ICU admission would be associated with ICU mortality.

METHODS: Ancillary analysis of single-center data prospectively collected from 220 communicative ICU subjects allocated to a derivation cohort of 120 subjects and a separate validation cohort of 100 subjects. Dyspnea was assessed dichotomously (yes/no), with a dyspnea visual analog scale (measured in mm), and IC-RDOS was calculated. Multivariate logistic regression was used to identify factors associated with ICU and hospital mortality.

RESULTS: Dyspnea was reported by 69 (58%; median 45 [interquartile range [IQR] 32–60] mm) and 47 (47%; 38 [IQR 26–48] mm) subjects in the derivation and validation cohorts, respectively. IC-RDOS was 2.3 (1.2–3.1) and 2.4 (1.3–2.8), respectively. IC-RDOS values were higher in subjects with dyspnea than in subjects without dyspnea in both the derivation cohort (2.6 [2.2–4.6] vs 1.4 [0.9–2.4], P < .001) and the validation cohort (2.6 [2.3–4.4] vs 2.2 [1.0–2.8], P < .001). On multivariate analysis of the derivation cohort, admission for hemorrhagic shock (odds ratio 13.98), IC-RDOS (odds ratio 1.77), and Simplified Acute Physiology Score II (odds ratio 1.10) was associated with ICU mortality. Areas under the receiving operating characteristic curve of IC-RDOS to predict ICU mortality were 0.785 and 0.794 in the derivation and validation cohorts, respectively.

CONCLUSIONS: IC-RDOS, an observational correlate of dyspnea, but not dyspnea itself, was associated with higher mortality in ICU subjects.

  • dyspnea
  • dyspnea observation scale
  • ICU
  • multidimensional dyspnea profile
  • prognosis

Footnotes

  • Correspondence: Maxens Decavèle MD, Department of Respiratory and Critical Care Medicine, Groupe Hospitalier Pitié-Salpêtrière, 47–83 Boulevard de l'Hôpital, 75013 Paris, France; phone: 33-1-42-16-77-61; Fax: 33-1-42-16-78-43. E-mail: maxens.decavele{at}aphp.fr
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Respiratory Care: 67 (7)
Respiratory Care
Vol. 67, Issue 7
1 Jul 2022
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Prognostic Value of the Intensive Care Respiratory Distress Observation Scale on ICU Admission
Maxens Decavèle, Isabelle Rivals, Romain Persichini, Julien Mayaux, Laure Serresse, Capucine Morélot-Panzini, Martin Dres, Alexandre Demoule, Thomas Similowski
Respiratory Care Apr 2022, respcare.09601; DOI: 10.4187/respcare.09601

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Prognostic Value of the Intensive Care Respiratory Distress Observation Scale on ICU Admission
Maxens Decavèle, Isabelle Rivals, Romain Persichini, Julien Mayaux, Laure Serresse, Capucine Morélot-Panzini, Martin Dres, Alexandre Demoule, Thomas Similowski
Respiratory Care Apr 2022, respcare.09601; DOI: 10.4187/respcare.09601
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  • ICU
  • multidimensional dyspnea profile
  • prognosis

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