Méndez CEA, Carballo ML

Language: Spanish
References: 15
Page: 104-108
PDF size: 592.34 Kb.

ABSTRACT

Introduction: early risk stratification in patients with acute coronary syndrome (ACS) is essential to optimize clinical decision-making. The diastolic respiratory index (DRI), calculated as HR/DBP + RR/SpO₂, is proposed as a non-invasive physiological tool for immediate application. Objective: to evaluate the performance of the DRI as a predictor of adverse outcomes: in-hospital mortality, progression to shock, and the need for mechanical ventilation (MV) in patients with ACS. Material and methods: observational, ambispective, analytical, and single-center study conducted in a cohort of 101 patients diagnosed with ACS. ROC curve analysis was applied to determine the optimal cutoff point for the DRI, and multivariable logistic regression models were developed to assess its independence as a predictor. Results: a total of 101 patients with ACS were analyzed, with a median age of 69 years and a predominance of males (67.3%). Adverse events occurred with the following frequencies: progression to shock in 34.7% of cases (n = 35), requirement of mechanical ventilation in 21.8% (n = 22), and in-hospital mortality in 19.8% (n = 20). The DRI showed its best performance for predicting MV (AUC = 0.759; cutoff = 1.40; sensitivity 72.7%; specificity 82.3%) and was also significant for shock and mortality. In the multivariable analysis, the DRI remained an independent predictor for all three outcomes: shock (OR = 2.60, p = 0.010), MV (OR = 3.72, p = 0.001), and in-hospital mortality (OR = 2.97, p = 0.007), outperforming other physiological variables and confirming its value as an early stratification tool. Conclusion: the DRI is an independent, non-invasive, and reliable predictor, with good discriminative capacity to anticipate adverse outcomes, particularly the need for MV in ACS patients, with an optimal cutoff point of 1.40 (p < 0.05).

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