PHÂN TÍCH MỐI LIÊN QUAN CỦA CHỈ SỐ PaO2 VÀ TỶ LỆ P/F VỚI TIÊN LƯỢNG Ở BỆNH NHÂN SUY HÔ HẤP CẤP TIẾN TRIỂN TẠI BỆNH VIỆN BẠCH MAI

Abstract

Objective: To analyze the association between arterial partial pressure of oxygen (PaO₂) and the PaO₂/FiO₂ ratio (P/F ratio) with mortality in patients with acute respiratory distress syndrome (ARDS), and to compare the prognostic value of oxygenation indices with several severity scoring systems reflecting overall systemic illness. Subjects and Methods: A retrospective descriptive study was conducted on 41 patients diagnosed with ARDS according to the Berlin 2012 criteria, who were treated at the A9 Emergency Center and the Intensive Care Unit of Bach Mai Hospital from August 2024 to August 2025. Clinical characteristics, arterial blood gas parameters, and severity scores (Berlin classification, SOFA, and APACHE II) were collected at hospital admission. The predictive performance of PaO₂, the P/F ratio, and severity scores for mortality was evaluated using the area under the receiver operating characteristic curve (AUC). Logistic regression analysis was performed to identify independent predictors of mortality. Results: The overall mortality rate in the study population was 73.2%. At hospital admission, lower PaO₂ demonstrated better predictive performance for mortality than the P/F ratio, with areas under the curve (AUCs) of 0.721 (p = 0.008) and 0.606 (p = 0.283), respectively. Among the severity scoring systems, APACHE II showed the highest predictive value with an AUC of 0.745 and was identified as an independent predictor of mortality (OR 1.289; p = 0.02). In addition, PaO₂ showed a strong positive correlation with the P/F ratio (Rs = 0.835; p < 0.001) and a negative correlation with the Berlin classification. Conclusion: Severity scores reflecting overall systemic illness, particularly APACHE II, provide better mortality prediction than isolated oxygenation indices in patients with ARDS.