Prognostic Value of the Intensive Care Respiratory Distress Observation Scale on ICU Admission.

ICU dyspnea dyspnea observation scale multidimensional dyspnea profile prognosis

Journal

Respiratory care
ISSN: 1943-3654
Titre abrégé: Respir Care
Pays: United States
ID NLM: 7510357

Informations de publication

Date de publication:
07 2022
Historique:
pubmed: 21 4 2022
medline: 23 6 2022
entrez: 20 4 2022
Statut: ppublish

Résumé

The association between dyspnea and mortality has not been demonstrated in the ICU setting. We tested the hypothesis that dyspnea (self-reported respiratory discomfort) or its observational correlates (5-item intensive care Respiratory Distress Observation Scale [IC-RDOS]) assessed on ICU admission would be associated with ICU mortality. Ancillary analysis of single-center data prospectively collected from 220 communicative ICU subjects allocated to a derivation cohort of 120 subjects and a separate validation cohort of 100 subjects. Dyspnea was assessed dichotomously (yes/no), with a dyspnea visual analog scale (measured in mm), and IC-RDOS was calculated. Multivariate logistic regression was used to identify factors associated with ICU and hospital mortality. Dyspnea was reported by 69 (58%; median 45 [interquartile range [IQR] 32-60] mm) and 47 (47%; 38 [IQR 26-48] mm) subjects in the derivation and validation cohorts, respectively. IC-RDOS was 2.3 (1.2-3.1) and 2.4 (1.3-2.8), respectively. IC-RDOS values were higher in subjects with dyspnea than in subjects without dyspnea in both the derivation cohort (2.6 [2.2-4.6] vs 1.4 [0.9-2.4], IC-RDOS, an observational correlate of dyspnea, but not dyspnea itself, was associated with higher mortality in ICU subjects.

Sections du résumé

BACKGROUND
The association between dyspnea and mortality has not been demonstrated in the ICU setting. We tested the hypothesis that dyspnea (self-reported respiratory discomfort) or its observational correlates (5-item intensive care Respiratory Distress Observation Scale [IC-RDOS]) assessed on ICU admission would be associated with ICU mortality.
METHODS
Ancillary analysis of single-center data prospectively collected from 220 communicative ICU subjects allocated to a derivation cohort of 120 subjects and a separate validation cohort of 100 subjects. Dyspnea was assessed dichotomously (yes/no), with a dyspnea visual analog scale (measured in mm), and IC-RDOS was calculated. Multivariate logistic regression was used to identify factors associated with ICU and hospital mortality.
RESULTS
Dyspnea was reported by 69 (58%; median 45 [interquartile range [IQR] 32-60] mm) and 47 (47%; 38 [IQR 26-48] mm) subjects in the derivation and validation cohorts, respectively. IC-RDOS was 2.3 (1.2-3.1) and 2.4 (1.3-2.8), respectively. IC-RDOS values were higher in subjects with dyspnea than in subjects without dyspnea in both the derivation cohort (2.6 [2.2-4.6] vs 1.4 [0.9-2.4],
CONCLUSIONS
IC-RDOS, an observational correlate of dyspnea, but not dyspnea itself, was associated with higher mortality in ICU subjects.

Identifiants

pubmed: 35440498
pii: respcare.09601
doi: 10.4187/respcare.09601
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

823-832

Informations de copyright

Copyright © 2022 by Daedalus Enterprises.

Déclaration de conflit d'intérêts

Dr Decavèle discloses a relationship with ISIS Medical. Dr Similowski discloses relationships with AstraZeneca France, Boerhinger Ingelheim France, Novartis France, Teva France, Chiesi France, Lungpacer, ADEP Assistance, and Air Liquide Medical Systems. Dr Demoule discloses relationships with Philips, Baxter, Fisher & Paykel, French Ministry of Health, Getinge, Respinor, Lungpacer, Löwenstein, and Gilead. Dr Dres discloses relationships with Lungpacer and BioSerenity. Dr Morélot-Panzini discloses relationships with AstraZeneca, GlaxoSmithKline, SOS Oxygène, ADEP, ISIS, ResMed, Chiesi, Menarini, Vivisol, Air Liquide, Löwenstein, and Fisher & Paykel. Dr Mayaux discloses a relationship with Gilead France. The remaining authors have disclosed no conflicts of interest.

Auteurs

Maxens Decavèle (M)

Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale Clinique, F-75005 Paris, France; and Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service Médecine Intensive et Réanimation (Département R3S), F-75013 Paris, France. maxens.decavele@aphp.fr.

Isabelle Rivals (I)

Equipe de Statistique Appliquée, ESPCI Paris, PSL Research University, Paris, France.

Romain Persichini (R)

Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service Médecine Intensive et Réanimation (Département R3S), F-75013 Paris, France.

Julien Mayaux (J)

Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service Médecine Intensive et Réanimation (Département R3S), F-75013 Paris, France.

Laure Serresse (L)

Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; and Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Unité Mobile d'Accompagnement et de Soins Palliatifs, Paris, France.

Capucine Morélot-Panzini (C)

Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; and Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service de Pneumologie (Département R3S), F-75013 Paris, France.

Martin Dres (M)

Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale Clinique, F-75005 Paris, France; and Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service Médecine Intensive et Réanimation (Département R3S), F-75013 Paris, France.

Alexandre Demoule (A)

Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale Clinique, F-75005 Paris, France; and Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Service Médecine Intensive et Réanimation (Département R3S), F-75013 Paris, France.

Thomas Similowski (T)

Sorbonne Université, INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, France; and Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Département R3S, F-75013 Paris, France.

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