New severity score of acute respiratory failure
© Allal et al.; licensee BioMed Central Ltd. 2012
Published: 20 March 2012
Score of respiratory failure
Accessory muscle use
30 to 40
Supraclavicular and/or suprasternal
A prospective study among 70 patients with ARF on previously healthy lungs. ARF was rated in a randomized blinded manner respectively by residents and seniors. An inter-rater reliability analysis using the kappa statistic was performed to determine consistency among raters. Clinimetric properties were assessed by examining the prognostic prediction by the ROC curve using a composite gold standard (PaO2/FiO2 <250 and/or ventilatory support).
The inter-rater reliability for the raters was found to be κ = 0.82 (P < 0.001), indicating an almost perfect agreement . The area under the ROC curve was revealed very interesting (AUC = 0.88) indicating an excellent prognostic predictive power.
This new and validated score could drive some advantages in daily practice, allowing accurate assessment of ARF severity, more objective monitoring of patients and easier communication between care providers. It may accurately guide oxygen supplementation and ventilatory support and afford accurate monitoring of patho-physiological and etiological treatment of ARF. It could be a valuable tool in randomized clinical trials or physiological studies evaluating treatments in ARF. Finally it could be used as an educational tool.
- Patrick W, Webster K, Ludwig L, Roberts D, Wiebe P, Younes M: Non-invasive positive pressure ventilation in acute respiratory distress without prior chronic respiratory failure. Am J Respir Crit Care Med 1996, 153: 1005-1011.View ArticlePubMedGoogle Scholar
- Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics 1977, 33: 159-174. 10.2307/2529310View ArticlePubMedGoogle Scholar
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