@article {Decav{\`e}lerespcare.09601, author = {Maxens Decav{\`e}le and Isabelle Rivals and Romain Persichini and Julien Mayaux and Laure Serresse and Capucine Mor{\'e}lot-Panzini and Martin Dres and Alexandre Demoule and Thomas Similowski}, title = {Prognostic Value of the Intensive Care Respiratory Distress Observation Scale on ICU Admission}, elocation-id = {respcare.09601}, year = {2022}, doi = {10.4187/respcare.09601}, publisher = {Respiratory Care}, 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{\textendash}60] mm) and 47 (47\%; 38 [IQR 26{\textendash}48] mm) subjects in the derivation and validation cohorts, respectively. IC-RDOS was 2.3 (1.2{\textendash}3.1) and 2.4 (1.3{\textendash}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{\textendash}4.6] vs 1.4 [0.9{\textendash}2.4], P \< .001) and the validation cohort (2.6 [2.3{\textendash}4.4] vs 2.2 [1.0{\textendash}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.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/early/2022/04/19/respcare.09601}, eprint = {https://rc.rcjournal.com/content/early/2022/04/19/respcare.09601.full.pdf}, journal = {Respiratory Care} }