A Comparative Analysis of Survival Prediction Using PRESERVE and RESP Scores.

Abstract

Venovenous (VV) extracorporeal membrane oxygenation (ECMO) can be a life-saving therapy for patients with severe acute lung failure refractory to conventional therapy. The respiratory ECMO survival prediction (RESP) score and the predicting death for severe acute respiratory distress syndrome on VV-ECMO (PRESERVE) score were created to predict survival at the time of initiation of ECMO. This study aimed to validate both of these scores externally and to compare their predictive accuracies in patients with non-Western acute respiratory distress syndrome (ARDS). In this retrospective cohort study, we reviewed and extracted data from electronic medical records of consecutive adult ARDS patients who were treated with VV-ECMO from 2007 to 2015. The PRESERVE and RESP scores were calculated for each patient. The outcomes of interest were inhospital and 6-month survival. In all, 99 patients were included. The mean age of the patients was 54 years, and male patients constituted 70% of the cohort. The inhospital and 6-month survival rates were 23% and 22%, respectively. Receiver-operating characteristics curve analysis of the PRESERVE and RESP scores showed area under the curve values of 0.64 and 0.69, respectively (p = 0.53), for inhospital survival. The receiver-operating characteristics areas under the curve for 6-month survival were 0.66 and 0.69, respectively (p = 0.68). The prognostic accuracies of the PRESERVE and RESP scores were thus similar. Both PRESERVE and RESP scores are useful for predicting survival in Asian ARDS patients, and both scores had similar prognostic accuracies in our Korean ARDS cohort.