TY - JOUR T1 - Prognostic value of the novel P/FPE index to classify ARDS severity: A cohort study JO - Medicina Intensiva (English Edition) T2 - AU - Martos-Benítez,F.D. AU - Estévez-Muguercia,R. AU - Orama-Requejo,V. AU - del Toro-Simoni,T. SN - 02105691 M3 - 10.1016/j.medin.2022.06.006 DO - 10.1016/j.medin.2022.06.006 UR - https://medintensiva.org/es-prognostic-value-novel-p-fpe-index-articulo-S0210569122002273 AB - ObjectiveTo evaluate the impact of the novel P/FPE index to classify ARDS severity on mortality of patients with ARDS. DesignA retrospective cohort study. SettingTwelve-bed medical and surgical intensive care unit from January 2018 to December 2020. PatientsA total of 217 ARDS patients managed with invasive mechanical ventilation >48h. InterventionsNone. VariablesARDS severity on day 1 and day 3 was measured based on PaO2/FiO2 ratio and P/FPE index [PaO2/(FiO2×PEEP)]. Primary outcome was the hospital mortality. ResultsHospital mortality rate was 59.9%. Relative to PaO2/FiO2 ratio, 31.8% of patients on day 1 and 77.0% on day 3 were reclassified into a different category of ARDS severity by P/FPE index. The level of PEEP was lower by P/FPE index-based ARDS severity classification than by using PaO2/FiO2 ratio. The performance for predicting mortality of P/FPE index was superior to PaO2/FiO2 ratio in term of AROC (day 1: 0.72 vs. 0.62; day 3: 0.87 vs. 0.68) and CORR (day 1: 0.370 vs. 0.213; day 3: 0.634 vs. 0.301). P/FPE index improved prediction of risk of death compared to PaO2/FiO2 ratio as showed by the qNRI (day 1: 72.0%, p<0.0001; day 3: 132.4%, p<0.0001) and IDI (day 1: 0.09, p<0.0001; day 3: 0.31, p<0.0001). ConclusionsAssessment of ARDS severity based on P/FPE index seems better than PaO2/FiO2 ratio for predicting mortality. The value of P/FPE index for clinical decision-making requires confirmation by randomized controlled trials. ER -