Clinical Outcome Prediction in Pediatric ARDS by Chest Radiograph Severity Scoring

Aim: To assesses the severity and prognosis of pediatric acute respiratory distress syndrome (PARDS) based on a chest radiograph (CXR) scoring method. Methods: 116 PARDS and 463 CXRs were selected. General demographics, pulmonary complications, and 28‐day mortality of the patients were recorded. Subgroup divided by prognosis (survive, death) and etiology (infection, non-infection). CXR scores were calculated for each of the four quadrants by infiltration extent (0-4) and density (1-3). The ROC curve and survival curve were established, the cut-off score for predicting prognosis was set. Results: The agreement between two independent observers was excellent (ICC=0.98, 95%CI:0.97-0.99). The hospital length of stay of death group was shorter than survive group, whereas the percentage of pulmonary complication of death group were significantly higher than survival group (all p<0.05). Day 3 score was independently associated with better survival (p<0.001). The aera under the curve of ROC was 0.773 (95%CI:0.709-0.838). The cut-off score was 21 (sensitivity 71.7%, specificity 76.5%), OR was 9.268 (95%CI: 1.257-68.320). The pulmonary complication showed an OR of 3.678 (95%CI: 1.174-11.521) for the prediction. Conclusions: CXR score can be used in PARDS for predicting prognosis and has a great agreement among radiologist and pediatrician. Pulmonary complication, Day 3 score whether greater than 21 points have a strong predictive effectiveness. Original Article Clinical Outcome Prediction in Pediatric ARDS by Chest Radiograph Severity Scoring Yu-Chun Yan 1 ·Wen-Han Hao 1 ·Feng-Sen Bai 1 ·Shuang Liu 2 ·Dong Qu 2 ·Xin-Yu Yuan 1 Department of Radiology, The Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing, China Department of Critical Medicine, The Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing, China ORCID: Yu-Chun Yan: 0000-0002-1423-2676 Wen-Han Hao: 0000-0002-5422-788X Feng-Sen Bai: 0000-0002-0337-8274 Shuang Liu: 0000-0002-0159-2357 Dong Qu: 0000-0003-1960-0797 Xin-Yu Yuan: 0000-0003-0964-8703 Corresponding Author: Xin-Yu Yuan, MD Department of Radiology, The Affiliated Children’s Hospital, Capital Institute of Pediatrics, Beijing, China No.2 Yabao Road, Chaoyang District, Beijing 100020, China Tel: 86-13911040671 Fax: 82-010-85623241 E-mail: [email protected] Author contribution: • Conceptualization: Dong Qu, Xin-Yu Yuan • Data curation: Yu-Chun Yan, Wen-Han Hao, Feng-Sen Bai, Shuang Liu • Formal analysis: Yu-Chun Yan • Funding acquisition: Yu-Chun Yan • Investigation: Yu-Chun Yan, Feng-Sen Bai, Shuang Liu • Methodology: Yu-Chun Yan • Project administration: Xin-Yu Yuan • Resources: Dong Qu, Xin-Yu Yuan • Software: Wen-Han Hao, Yu-Chun Yan, • Supervision: Dong Qu, Xin-Yu Yuan • Validation: Yu-Chun Yan, Feng-Sen Bai • Visualization: Yu-Chun Yan, Wen-Han Hao, Feng-Sen Bai • Writing-original draft: Yu-Chun Yan • Writing-review & editing: Xin-Yu Yuan Ethics Committee : Capital Institute of Pediatrics (KSSHERLL2018005) Word count (abstract) : 211 Word count (main text) : 1771 Table number : 3 Figure number : 5 Conflicts of interest: The authors declare that they have no conflict of interest. Funding: Beijing Municipal Science and Technology Project, Capital characteristic clinical application of China (Z181100001718169).

We thank for the fund of Beijing Municipal Science and Technology Project, Capital characteristic clinical application of China (Z181100001718169). Supplementary Material File (pards-cxr.docx) - Download - 1.22 MB Information & Authors Information Version history Copyright This work is licensed under a Non Exclusive No Reuse License.

Authors Metrics & Citations Metrics Article Usage 282views 124downloads Citations Download citation Yuchun Yan, Wenhan Hao, Fengsen Bai, et al. Clinical Outcome Prediction in Pediatric ARDS by Chest Radiograph Severity Scoring. Authorea. 31 January 2024. DOI: https://doi.org/10.22541/au.170669690.00449793/v1 DOI: https://doi.org/10.22541/au.170669690.00449793/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu.