TY - JOUR T1 - Risk stratification using SpO2/FiO2 and PEEP in COVID-19 ARDS JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2021.PA896 VL - 58 IS - suppl 65 SP - PA896 AU - Jan-Paul Roozeman AU - Ary Serpa Neto AU - Markus W Hollmann AU - Frederique Paulus AU - Marcus J Schultz AU - Guido Mazzinari AU - Luigi Pisani Y1 - 2021/09/05 UR - http://erj.ersjournals.com/content/58/suppl_65/PA896.abstract N2 - Background: The SpO2 to FiO2 ratio (S/F) is an easy to obtain and widely available oxygenation index with proven prognostic value in ARDS patients.Aim: To ascertain the prognostic value of S/F and PEEP in COVID-19 ARDS patients.Methods: Multicenter observational study in 22 ICUs in the Netherlands. 867 patients were stratified into four risk groups using 190 as the cutoff for S/F and 10 cm H2O as the cutoff for PEEP, on the day of the start of ventilation (day 0) and after 24 hours (day 1). The primary outcome was 28-day mortality.Results: Risk stratification on day 0 resulted in groups with contrasting 28-day mortality and other endpoints; risk stratification on day 1 increased contrast in the outcomes.Conclusions: Risk classification using S/F and PEEP has prognostic value in COVID-19 ARDS patients, which improves with reclassification on day 1. Group IGroup IIGroup IIIGroup IVp-valueSpO2/FiO2 ≥ 190 and PEEP < 10SpO2/FiO2 ≥190 and PEEP ≥10SpO2/FiO2 < 190 and PEEP < 10SpO2/FiO2 < 190 and PEEP ≥ 10Day 0N=1813950660ICU mortality6 (33%)29 (22%)18 (36%)241 (31%) 0.002 28 day mortality5 (28%)29 (21%)17 (34%)217 (33%)0.015ICU length of stay11 [7-23]14 [9-25]14 [9-24]16 [9-27]0.358Duration of ventilation9 [4-18]13 [7-23]12 [6-20]14 [8-23]0.136Ventilator free days on day 2815 [0-23]9 [0-19]2 [0-19]0 [0-15]0.002Day 1N=5735937414ICU mortality18 (32%)99 (28%)16 (46%)161 (40%)0,00228 day mortality17 (30%)87 (25%)14 (38%)150 (37%)0,001ICU length of stay10 [5-23]15 [9-26]15 [10-23]17 [9-29]0,004Duration of ventilation9 [4-18]14 [8-22]12 [7-20]15 [8-24]0.001Ventilator free days on day 2814 [0-22]7 [0-17]0 [0-18]0 [0-13]<0.001FootnotesCite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA896.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). ER -