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タイトル: Predictive Value of the PaO₂/FIO₂ Ratio for Mortality in Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-analysis
著者: Yoshimura, Satoshi
Hashimoto, Katsuhiko
Shono, Yuji
Tamura, Takahiro
Uchimido, Ryo
Ando, Koichi
Okamori, Satoshi
Yoshida, Takuo
Yoshitake, Shigenori
Okada, Yohei
キーワード: emergency medicine
critical care
intensive care
systematic review
meta-analysis
acute respiratory distress syndrome
発行日: 2025
出版者: Japanese Society of Internal Medicine
誌名: Internal Medicine
論文番号: 4292-24
抄録: [Background] Despite the controversy regarding its clinical utility, the PaO₂/FIO₂ ratio has been used to define the severity of acute respiratory distress syndrome (ARDS). This systematic review and meta-analysis (SRMA) details summary estimates of the predictive performance of PaO₂/FIO₂ ratio in predicting mortality in patients with ARDS. [Methods] To clarify the integrated diagnostic accuracy, we included studies in which the study population comprised patients with ARDS in any clinical setting, included adult patients (≥18 years old), and evaluated mortality. The MEDLINE and Cochrane Central Registry of Controlled Trials databases were searched for articles in English. We performed SRMA on the accuracy of the diagnostic prognostic tests using the Quality Assessment of Diagnostic Accuracy Studies-2 tool to evaluate the risk of bias. We obtained summary point estimates of sensitivity and specificity and calculated the area under the receiver operating characteristic (AUROC) curve of the summary receiver operating characteristic curve with 95% confidence intervals (CIs). [Results] Twenty-eight trials with 38270 patients were included in the quality assessment. Most of the studies were conducted in intensive-care units. Overall, the risk of bias is high. For PaO₂/FIO₂ of 100 and 200 the pooled sensitivity, specificity, and AUROC were 44.8% (95% CI, 38.1%-51.7%), 70.6% (95% CI, 65.9%-74.9%), 0.60 (0.58-0.64) and 83.9% (95% CI, 78.9%-87.8%), 26.1% (95% CI, 20.8%-32.1%), 0.64 (0.60-0.69), respectively. [Conclusion] The PaO₂/FIO₂ ratio alone did not have impressive prediction accuracy for mortality in patients with ARDS and might not be able to be used solely as a clinical prognostic tool.
著作権等: © 2025 by The Japanese Society of Internal Medicine
This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
URI: http://hdl.handle.net/2433/292154
DOI(出版社版): 10.2169/internalmedicine.4292-24
PubMed ID: 39631866
出現コレクション:学術雑誌掲載論文等

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