• Lixue Huang, Man Song, Yan Liu, Wenmei Zhang, Zhenye Pei, Nan Liu, Ming Jia, Xiaotong Hou, Haibo Zhang, Jinhua Li, Xiangrong Cao, and Guangfa Zhu.
• Lixue Huang is a clinician, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
• Am. J. Crit. Care. 2021 Jan 1; 30 (1): 64-71.

BackgroundDespite advances in treatment strategies, acute respiratory distress syndrome (ARDS) after cardiac surgery remains associated with high morbidity and mortality. A method of screening patients for risk of ARDS after cardiac surgery is needed.ObjectivesTo develop and validate an ARDS prediction score designed to identify patients at high risk of ARDS after cardiac or aortic surgery.MethodsAn ARDS prediction score was derived from a retrospective derivation cohort and validated in a prospective cohort. Discrimination and calibration of the score were assessed with area under the receiver operating characteristic curve and the Hosmer-Lemeshow goodness-of-fit test, respectively. A sensitivity analysis was conducted to assess model performance at different cutoff points.ResultsThe retrospective derivation cohort consisted of 201 patients with and 602 patients without ARDS who had undergone cardiac or aortic surgery. Nine routinely available clinical variables were included in the ARDS prediction score. In the derivation cohort, the score distinguished patients with versus without ARDS with area under the curve of 0.84 (95% CI, 0.81-0.88; Hosmer-Lemeshow P = .55). In the validation cohort, 46 of 1834 patients (2.5%) had ARDS develop within 7 days after cardiac or aortic surgery. Area under the curve was 0.78 (95% CI, 0.71-0.85), and the score was well calibrated (Hosmer-Lemeshow P = .53).ConclusionsThe ARDS prediction score can be used to identify high-risk patients from the first day after cardiac or aortic surgery. Patients with a score of 3 or greater should be closely monitored. The score requires external validation before clinical use.©2021 American Association of Critical-Care Nurses.

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