The ability of COVID-19 to compromise the respiratory system has generated a substantial proportion of critically ill patients in need of invasive mechanical ventilation (IMV). The objective of this paper was to analyze the prognostic ability of the pulse oximetry saturation/fraction of inspired oxygen ratio (SpO2/FiO2) and the ratio of SpO2/FiO2 to the respiratory rate–ROX index–as predictors of IMV in an emergency department in confirmed COVID-19 patients. A multicenter, retrospective cohort study was carried out in four provinces of Spain between March and November 2020. The discriminative power of the predictive variable was assessed through a prediction model trained using a derivation sub-cohort and evaluated by the area under the curve (AUC) of the receiver operating characteristic (ROC) on the validation sub-cohort. A total of 2040 patients were included in the study. The IMV rate was 10.1%, with an in-hospital mortality rate of 35.3%. The performance of the SpO2/FiO2 ratio was better than the ROX index–AUC = 0.801 (95% CI 0.746–0.855) and AUC = 0.725 (95% CI 0.652–0.798), respectively. In fact, a direct comparison between AUCs resulted in significant differences ( p = 0.001). SpO2 to FiO2 ratio is a simple and promising non-invasive tool for predicting risk of IMV in patients infected with COVID-19, and it is realizable in emergency departments.
【저자키워드】 COVID-19, mechanical ventilation, Hypoxemia, Emergency Care, Risk scores, clinical decision making, 【초록키워드】 pulse oximetry, risk, oxygen, ROC, Patient, Spain, Respiratory system, predictor, multicenter, prognostic, characteristic, COVID-19 patients, Invasive mechanical ventilation, AUC, Predictive, Critically ill patient, retrospective cohort study, Non-invasive, significant difference, FiO2, SpO2, 95% CI, in-hospital mortality rate, SpO2/FiO2, IMV, ROX, carried, proportion, evaluated, infected with COVID-19, sub-cohort, 【제목키워드】 index, SpO2/FiO2, role, ROX, Ratio, Mechanical,