RT Journal Article
SR Electronic
T1 The radiographic assessment of lung edema (RALE) score has excellent diagnostic accuracy for ARDS
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP OA3299
DO 10.1183/13993003.congress-2019.OA3299
VO 54
IS suppl 63
A1 Claudio Zimatore
A1 Luigi Pisani
A1 Valeria Lippolis
A1 Carolyn S Calfee
A1 Lorraine B Ware
A1 Anna Geke Algera
A1 Marry R Smit
A1 Salvatore Grasso
A1 Marcus J Schultz
YR 2019
UL http://erj.ersjournals.com/content/54/suppl_63/OA3299.abstract
AB Background: The chest X–ray (CXR) is part of the current ARDS definition (JAMA 2012; 307:2526) but detains poor interobserver reliability. The RALE score was recently proposed to evaluate lung edema on CXR in ARDS patients (Thorax 2018; 73: 840; figure 1A). The current study determined its diagnostic accuracy for ARDS in a cohort of ICU patients expected to need invasive ventilation for >24 hours.Methods: The current ARDS definition was used as the gold standard. The RALE score was calculated for the first available CXR. ROC curves were constructed, and the optimal cutoff was used to determine sensitivity, specificity, negative and positive predictive value of the RALE score for ARDS.Results: The study included 144 patients, of whom 33 had ARDS according to the current ARDS definition. A higher RALE score was found in patients with ARDS compared to patients without ARDS (23 [16–33] vs 7 [3–11]; P<0.001). The optimal RALE score cutoff was 9 (figure 1B). Agreement on the RALE score between two independent researchers was excellent, with an interclass coefficient of 0.95 (95%CI 0.92–0.96).Conclusions: In this cohort of invasively ventilated ICU patients, the RALE score had an excellent diagnostic accuracy for ARDS, was easy to calculate, feasible and reliable. Additional validation of the cutoff and RALE performance is needed in larger cohorts.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, OA3299.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).