Villar et al reported the SPIRES score to evaluate a patient with ARDS in the ICU. This can help to identify a patient who may require more aggressive management. The authors are primarily from multiple hospitals in Spain.
Patient selection: ICU patient with the acute respiratory distress syndrome
Parameters:
(1) age of the patient in years
(2) number of extrapulmonary organ failures at 24 hours of diagnosis of ARDS
(3) PaO2 to FIO2 ratio at 24 hours
(4) plateau press at 24 hours in cm H2O
Parameter
Finding
Points
age of the patient
< 50 years
1
50 to 70 years
2
> 70 years
3
extrapulmonary organ failures
0 or 1
1
2
2
3 or more
3
PaO2 to FIO2 ratio
>200
1
101 to 200
2
<= 100
3
plateau pressure
< 29 cm H2O
1
29 to 30
2
> 30 cm H2O
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 4
• maximum score: 12
Total Score
Category
ICU Mortality
4 to 7
Class 1
15%
8
Class 2
50%
9 to 12
Class 3
83%
Performance:
• The area under the ROC curve is 0.87.
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