Abstract
INTRODUCTION: New scenarios and techniques, such as Intermediate Care Units (ImCU) and Non-Invasive Ventilation (NIV) make necessary to validate and in some cases to adequate mortality scores to different populations.
OBJECTIVE: To elucidate mortality predicition factors in NIV users of an ImCU cohort using SAPS II and 3.
MATERIALS AND METHODS: According to previous published criteria and indications, 241 patients received NIV from a cohort of 743, in a single center ImCU. Logistic regression analysis was carried out on NIV users to find mortality predicting variables.
RESULTS: Logistic regression of SAPS II and 3 separately adjusted by NIV resulted in a OR for NIV of 2.84 and 1.98 respectively (p<0.01 in both cases). AUROC curves for SAPS II and 3 of the NIV cohort was 0.73 and 0.69 respectively, with an observed mortality of 32.4%. In the control group the AUROC for the same scores was of 0.76, with an observed mortality of 13.5%. Regression analysis in search of new predicting variables was done, with metastatic cancer, inmmunosupresive therapy, previous diagnosis of COPD, acute pulmonary edema (APE), pCO2 and hemoglobin levels as statistically significant variables. Age, systolic blood pressure (SBP) under 100 mmHg and a PaO2/FiO2 < 200 showed marginal statistical signification in predicting mortality.
CONCLUSION: SAPS II and 3 need to be customized in patients undergoing NIV, in order to improve mortality prediction. The new variables described, should be considered in new specific scores for NIV population.
- © 2014 ERS