The Predictive Value of APACHEⅡ Score and von Willebrand Factor on Severity and Prognosis of Acute Respiratory Distress Syndrome_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

 YuanChao ¹ , JinNa ²

1. The Department of Critical Care Medicine, Hubei Provincial Hospital of Integrated Chinese & Western Medicine,Wuhan, Hubei, 430015, China;
2. ;

Corresponding?author：

Keywords：

Acute physiology and chronic health evaluation Ⅱ; von Willebrand factor; Acute respiratory distress syndrome; Prognosis

DOI：

10.7507/1671-6205.2016034

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Objective To analyze the predictive value of von Willebrand factor (vWF) and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score on severity and prognosis of acute respiratory distress syndrome (ARDS). Methods The ARDS patients who were admitted between January 2010 and May 2012 were recruited in the study. APACHEⅡ score and plasma vWF were detected on the first day and the third day after diagnose of ARDS. The patients were divided intoasurvival group andadeath group according the prognosis. The predictive value of vWF and APACHEⅡ score on prognosis were analyzed by the receiver operating characteristic (ROC) curve. Lung injury score was calculated and its relationship with vWF and APACHEⅡ score were analyzed. Results One-hundred and twelve cases of ARDS were enrolled. There were no significant differences between the survival group and the death group in sex, age, respiration rate, blood pressure, white blood cells, procalcitonin or C-reactive protein (P > 0.05). On the first day after diagnosis of ARDS, the APACHEⅡ score and vWF level of the survival group were significantly lower than those in the death group (P < 0.05). On the third day, the APACHEⅡ score was increased but vWF level declined compared with those on the first day (P < 0.05). On the first day, lung injury score of the survival group was 1.7±0.4, significantly lower than that in the death group (2.5±0.6). On the third day, lung injury score in the survival group decreased, while lung injury score of the death group was significantly increased (P < 0.05). On the first day, vWF and APACHEⅡ score were positively correlated with lung injury score (r=0.75, P < 0.05; r=0.79, P < 0.05), respectively. On the first day, the area under the ROC curve of APACHEⅡ score and vWF were 0.87 and 0.91, respectively (P < 0.05). Conclusion APACHEⅡ score and vWF have high diagnostic value in evaluating the degree of lung injury and predicting the prognosis of patients with ARDS.

Citation： YuanChao, JinNa. The Predictive Value of APACHEⅡ Score and von Willebrand Factor on Severity and Prognosis of Acute Respiratory Distress Syndrome. Chinese Journal of Respiratory and Critical Care Medicine, 2016, 15(2): 142-146. doi: 10.7507/1671-6205.2016034 Copy

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2.	Eachempati SR, Hydo LJ, Shou J, et al. Outcomes of acute respiratory distress syndrome (ARDS) in elderly patients. J Trauma, 2007, 63:344-350.
3.	Bauer TT, Valencia M, Badia JR, et al. Respiratory microbiology patterns within the first 24 h of ARDS diagnosis: influence on outcome. Chest, 2005, 128:273-279.
4.	van der Heijden M, van Nieuw Amerongen GP, Koolwijk P, et al. Angiopoietin-2, permeability oedema, occurrence and severity of ALI/ARDS in septic and non-septic critically ill patients. Thorax, 2008, 63:903-909.
5.	夏炎火, 林錫芳, 潘景業, 等.血漿vWF:Ag、蛋白C活性在ALI/ARDS患者診斷和預后中的意義.醫學研究雜志, 2013, 42: 89-93.
6.	Wu WH, Niu YY, Zhang CR, et al. Combined APACH Ⅱ score and arterial blood lactate clearance rate to predict the prognosis of ARDS patients. Asian Pac J Trop Med, 2012, 5:656-660.
7.	Hodgson CL, Tuxen DV, Bailey MJ, et al. A positive response to a recruitment maneuver with PEEP titration in patients with ARDS, regardless of transient oxygen desaturation during the maneuver. J Intensive Care Med, 2011, 26:41-49.
8.	Fengmei G, Jin C, Songqiao L, et al. Dead space fraction changes during PEEP titration following lung recruitment in patients with ARDS. Respir Care, 2012, 57:1578-1585.
9.	虞志新, 金兆展, 吉木森.血清白介素6含量的變化與APACHEⅡ評分在急性呼吸窘迫綜合征患者中的臨床意義.國際呼吸雜志, 2011, 31:103-105.
10.	Aydogdu M, Ozyilmaz E, Aksoy H, et al. Mortality prediction in community-acquired pneumonia requiring mechanical ventilation; values of pneumonia and intensive care unit severity scores. Tuberk Toraks, 2010, 58:25-34.
11.	Dossett LA, Redhage LA, Sawyer RG, et al. Revisiting the validity of APACHEⅡ in the trauma ICU: Improved risk stratification in critically injured adults. Injury, 2009, 40:993-998.
12.	楊曉帆, 王君一, 田六九, 等.ARDS患者中APACHEⅡ評分及CRP值對呼吸機應用的指導意義.中國醫藥導報, 2011, 8: 46-47.
13.	孫杰, 張小坤, 張麗麗.分化綜合征合并急性呼吸窘迫綜合征的臨床診治分析.中國全科醫學, 2013, 16: 190-192.

1. ?Buttenschoen K, Kornmann M, Berger D, et al. Endotoxemia and endotoxin tolerance in patients with ARDS. Langenbecks Arch Surg, 2008, 393:473-478.
2. Eachempati SR, Hydo LJ, Shou J, et al. Outcomes of acute respiratory distress syndrome (ARDS) in elderly patients. J Trauma, 2007, 63:344-350.
3. Bauer TT, Valencia M, Badia JR, et al. Respiratory microbiology patterns within the first 24 h of ARDS diagnosis: influence on outcome. Chest, 2005, 128:273-279.
4. van der Heijden M, van Nieuw Amerongen GP, Koolwijk P, et al. Angiopoietin-2, permeability oedema, occurrence and severity of ALI/ARDS in septic and non-septic critically ill patients. Thorax, 2008, 63:903-909.
5. 夏炎火, 林錫芳, 潘景業, 等.血漿vWF:Ag、蛋白C活性在ALI/ARDS患者診斷和預后中的意義.醫學研究雜志, 2013, 42: 89-93.
6. Wu WH, Niu YY, Zhang CR, et al. Combined APACH Ⅱ score and arterial blood lactate clearance rate to predict the prognosis of ARDS patients. Asian Pac J Trop Med, 2012, 5:656-660.
7. Hodgson CL, Tuxen DV, Bailey MJ, et al. A positive response to a recruitment maneuver with PEEP titration in patients with ARDS, regardless of transient oxygen desaturation during the maneuver. J Intensive Care Med, 2011, 26:41-49.
8. Fengmei G, Jin C, Songqiao L, et al. Dead space fraction changes during PEEP titration following lung recruitment in patients with ARDS. Respir Care, 2012, 57:1578-1585.
9. 虞志新, 金兆展, 吉木森.血清白介素6含量的變化與APACHEⅡ評分在急性呼吸窘迫綜合征患者中的臨床意義.國際呼吸雜志, 2011, 31:103-105.
10. Aydogdu M, Ozyilmaz E, Aksoy H, et al. Mortality prediction in community-acquired pneumonia requiring mechanical ventilation; values of pneumonia and intensive care unit severity scores. Tuberk Toraks, 2010, 58:25-34.
11. Dossett LA, Redhage LA, Sawyer RG, et al. Revisiting the validity of APACHEⅡ in the trauma ICU: Improved risk stratification in critically injured adults. Injury, 2009, 40:993-998.
12. 楊曉帆, 王君一, 田六九, 等.ARDS患者中APACHEⅡ評分及CRP值對呼吸機應用的指導意義.中國醫藥導報, 2011, 8: 46-47.
13. 孫杰, 張小坤, 張麗麗.分化綜合征合并急性呼吸窘迫綜合征的臨床診治分析.中國全科醫學, 2013, 16: 190-192.

Chinese Journal of Respiratory and Critical Care Medicine

The Predictive Value of APACHEⅡ Score and von Willebrand Factor on Severity and Prognosis of Acute Respiratory Distress Syndrome

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