RT Journal Article
SR Electronic
T1 Prognostic Value of the Intensive Care Respiratory Distress Observation Scale on ICU Admission
JF Respiratory Care
FD American Association for Respiratory Care
SP 823
OP 832
DO 10.4187/respcare.09601
VO 67
IS 7
A1 Maxens Decavèle
A1 Isabelle Rivals
A1 Romain Persichini
A1 Julien Mayaux
A1 Laure Serresse
A1 Capucine Morélot-Panzini
A1 Martin Dres
A1 Alexandre Demoule
A1 Thomas Similowski
YR 2022
UL http://rc.rcjournal.com/content/67/7/823.abstract
AB 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.