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Revising risk stratification in mechanically ventilated ICU patients: the longitudinal European BioVent study

Lucas Boeck, Hans Pargger, Peter Schellongowski, Charles-Edouard Luyt, Marco Maggiorini, Kathleen Jahn, Jean Chastre, Rene Lötscher, Evelyne Bucher, Nadine Cueni, Martin Siegemund, Thomas Staudinger, Michael Tamm, Daiana Stolz
European Respiratory Journal 2021 58: PA3778; DOI: 10.1183/13993003.congress-2021.PA3778
Lucas Boeck
1Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
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  • For correspondence: lucas.boeck@unibas.ch
Hans Pargger
2Department of Anaesthesia and Surgical Intensive Care Medicine, University Hospital Basel, Basel, Switzerland
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Peter Schellongowski
3Department of Internal Medicine I, University Hospital Vienna, Vienna, Austria
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Charles-Edouard Luyt
4Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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Marco Maggiorini
5Department of Internal Medicine, Intensive Care Unit, University Hospital Zürich, Zürich, Switzerland
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Kathleen Jahn
1Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
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Jean Chastre
4Service de Réanimation Médicale, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
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Rene Lötscher
6Surgical and Medical Intensive Care Medicine, Kantonsspital Baselland, Liestal, Liestal, Switzerland
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Evelyne Bucher
2Department of Anaesthesia and Surgical Intensive Care Medicine, University Hospital Basel, Basel, Switzerland
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Nadine Cueni
2Department of Anaesthesia and Surgical Intensive Care Medicine, University Hospital Basel, Basel, Switzerland
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Martin Siegemund
2Department of Anaesthesia and Surgical Intensive Care Medicine, University Hospital Basel, Basel, Switzerland
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Thomas Staudinger
3Department of Internal Medicine I, University Hospital Vienna, Vienna, Austria
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Michael Tamm
1Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
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Daiana Stolz
1Clinic of Pulmonary Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
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Abstract

Background: The assessment of disease severity is an essential part of medical evaluation across all disciplines, allowing patient-tailored treatment regimens. Risk assessment is particularly important in intensive care, where improved therapy may translate to a gain in many life-years; however, intensive care can be a limited resource, has tremendous costs and may prolong suffering. Our goal was to assess and combine various tools to advance risk assessment in mechanically ventilated ICU patients.

Methods: BioVent (Biomarkers for mechanically ventilated patients) is a prospective investigator-initiated longitudinal cohort study including five centers across three European countries (Austria, France, Switzerland; ISRCTN59376582). In total 961 patients mechanically ventilated for at least 12 hours were included. Over 100 predictors were obtained at inclusion and throughout ICU stay, and assessed for predicting 28-day and 1-year survival. New prediction models were proposed and thoroughly validated.

Results: We revealed markers of renal disease, novel biomarkers as well as subjective survival estimates (from physicians and nurses) among the best single variables predicting 28-day survival. We then pooled all variables into three groups, namely patient characteristics, biomarkers and subjective survival estimates. Regression models revealed AUCs of 0.67, 0.77 and 0.80, respectively. Combining all markers increased model performance to an AUC of 0.85, outperforming SAPS2 and SOFA.

Conclusions: We conclude that combinations of novel biomarker and especially subjective survival estimates outperform traditional risk assessment tools in mechanically ventilated ICU patients.

  • Biomarkers
  • Critically ill patients
  • Mechanical ventilation - ventilator-associated

Footnotes

Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3778.

This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2021
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Revising risk stratification in mechanically ventilated ICU patients: the longitudinal European BioVent study
Lucas Boeck, Hans Pargger, Peter Schellongowski, Charles-Edouard Luyt, Marco Maggiorini, Kathleen Jahn, Jean Chastre, Rene Lötscher, Evelyne Bucher, Nadine Cueni, Martin Siegemund, Thomas Staudinger, Michael Tamm, Daiana Stolz
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3778; DOI: 10.1183/13993003.congress-2021.PA3778

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Revising risk stratification in mechanically ventilated ICU patients: the longitudinal European BioVent study
Lucas Boeck, Hans Pargger, Peter Schellongowski, Charles-Edouard Luyt, Marco Maggiorini, Kathleen Jahn, Jean Chastre, Rene Lötscher, Evelyne Bucher, Nadine Cueni, Martin Siegemund, Thomas Staudinger, Michael Tamm, Daiana Stolz
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3778; DOI: 10.1183/13993003.congress-2021.PA3778
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