BACKGROUND A predictive scoring system for acute respiratory distress syndrome (ARDS) patients, which incorporates age, PaO2/FlO2, and plateau pressure, APPS, was developed recently. It was validated externally in a Caucasian population but has not been studied in Asian populations. The aim of this study was to validate APPS in Korean ARDS patients. METHODS We retrospectively reviewed the medical records of patients who were diagnosed with ARDS using the Berlin criteria and admitted to the medical ICU at Seoul National University Hospital from January 2015 to December 2016. The validation of the APPS was performed by evaluating its calibration and predictive accuracy. Its calibration was plotted and quantified using the Hosmer-Lemeshow test. Its predictive accuracy was assessed by calculating the area under the receiver operating characteristics (AUC-ROC) curve. RESULTS A total of 116 patients were analyzed, 32 of whom survived. Of the 116 patients, 11 (9.5%) were classified as APPS grade 1 (score 3-4), 88 (75.9%) as grade 2 (score 5-7) and 17 (14.6%) as grade 3 (score 8-9). In-hospital mortality was 27.3% for grade 1, 73.9% for grade 2 and 94.1% for grade 3 (P for trend < 0.001). The APPS was well calibrated (Hosmer-Lemeshow test, P = 0.578) and its predictive accuracy was acceptable (AUC-ROC 0.704, 95% confidence interval 0.599-0.809). CONCLUSIONS The APPS predicted in-hospital mortality in Korean patients with ARDS with similar power to its application in a Western population and with acceptable predictive accuracy. TRIAL REGISTRATION Retrospectively registered.

中文翻译：

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对韩国急性呼吸窘迫综合征患者的年龄，PaO2 / FlO2和高原压力评分的验证：一项回顾性队列研究。

背景技术最近开发了一种针对急性呼吸窘迫综合征（ARDS）患者的预测评分系统，其包括年龄PaO 2 / FlO 2和高原压力APPS。它已在白种人人群中得到外部验证，但尚未在亚洲人群中进行研究。这项研究的目的是验证韩国ARDS患者中的APPS。方法我们回顾性分析了2015年1月至2016年12月根据柏林标准诊断为ARDS并入首尔国立大学医院的ICU的患者的病历。通过评估APPS的校准和预测准确性对APPS进行验证。使用Hosmer-Lemeshow测试绘制其校准图并进行量化。通过计算接收器工作特性（AUC-ROC）曲线下的面积来评估其预测精度。结果共分析了116例患者，其中32例存活。在116位患者中，有11位（9.5％）被分类为APPS 1级（3-4分），88位（75.9％）被归为2级（5-7分）和17位（14.6％）被归为3级（8分）。 9）。1级患者的院内死亡率为27.3％，2级患者为73.9％，3级患者为94.1％（趋势<0.001的P）。APPS进行了很好的校准（Hosmer-Lemeshow测试，P = 0.578），其预测准确性是可以接受的（AUC-ROC 0.704，95％置信区间0.599-0.809）。结论APPS预测了韩国ARDS患者的院内死亡率，与在西方人群中的应用具有相似的功效，并且具有可接受的预测准确性。试用注册追溯注册。