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ORIGINAL ARTICLE
Year : 2019  |  Volume : 47  |  Issue : 2  |  Page : 87-94

Comparative study between different scores predicting outcome in mechanically ventilated patients


1 Department of Chest, Faculty of Medicine, Tanta University, Tanta, Egypt
2 Department of Chest Diseases, Faculty of Medicine, Tanta University, Tanta, Egypt
3 Department of Anaesthesia & Surgical ICU, Faculty of Medicine, Tanta University, Tanta, Egypt

Correspondence Address:
Eman M.A Abedo
MSc of Chest Diseases, Algalaa Street, Kotour, Tanta
Egypt
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DOI: 10.4103/tmj.tmj_40_17

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Background The use of severity scoring systems was considered as a predictor of mortality in mechanically ventilated patients with respiratory failure due to respiratory and nonrespiratory causes. Aim To compare some new and simplified scores with traditional scores as predictors of outcome of mechanically ventilated patients with acute respiratory failure due to respiratory and nonrespiratory causes. Patients and methods The present study was carried out on 30 patients with respiratory failure due to respiratory and nonrespiratory causes who were mechanically ventilated and classified into three groups with respect to the cause of respiratory failure: group І included 10 mechanically ventilated patients due to chronic obstructive pulmonary disease exacerbation, group ІІ included 10 mechanically ventilated patients due to pneumonia, and group ІІІ included 10 mechanically ventilated patients due to nonrespiratory cause. Clinical and demographic data and routine investigations were done for all patients and then acute physiology and chronic health evaluation score (APACHE ІІІ) score was measured within 24 h of admission. Moreover, other scores including oxygenation index (OI), integrative weaning index (IWI), alveolar–arterial gradient (A–aO2), arterial oxygen tension (PaO2)/fraction of inspired oxygen (FiO2) ratio, and PaO2 were measured after 4 h, 24 h and after 3 days of ventilation. Results Nonsurvivors had significantly longer duration of ventilation, higher APACHE ІІІ score with cutoff value more than 57, higher OI mostly after 3 days of ventilation, significantly lower PaO2/FiO2 ratio as compared with survivors, IWI was significantly lower in nonsurvivors only in group І, pA–aO2 was significantly higher in nonsurvivors, and PaO2 had insignificant relation with mortality. Conclusion APACHE ІІІ score, PaO2/FiO2 ratio, A–aO2, and OI after 3 days of ventilation were the parameters that independently predicted mortality of mechanically ventilated patients, and also IWI predicted mortality only in group І and PaO2 did not predict mortality in all groups.


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