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May 2, 20260 citations

Improving ARDS Case-Finding Using a 72-Hour Physiologic Persistence Rule

Improving retrospective ARDS case-finding using a simple 72-h physiologic persistence rule.

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Authors

DMDominic C MarshallBPB. PatelAGAnthony Gordon

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Overview

Retrospective cohort study explores a 72-hour hypoxaemia rule for ARDS diagnosis, suggesting improved identification methods.

Key Points

  • The aim was to determine if a 72-hour persistence criterion for hypoxaemia improves ARDS case identification accuracy.
  • Conducted a retrospective cohort study using MIMIC-IV database (2008-2019) for derivation and a UK ICU (2009-2024) for validation.
  • Identified patients based on Berlin physiologic criteria for at least 72 hours and performed expert adjudication on a random sample of 2000 patients.
  • Compared diagnostic performance of radiology keyword searches and ICD codes.
  • 3940 out of 18,621 patients met the 72-hour persistence threshold for ARDS.
  • In the MIMIC-IV cohort, expert adjudication identified ARDS in 49.7%; in the UK validation cohort, it was 56%.
  • Prevalence decreased with shorter persistence: 21% after 48 h, 8% after 24 h, and 6% after single measurements.

Cite This Study

Marshall et al. (2026) studied this question.

synapsesocial.com/papers/69f594e171405d493afffbebhttps://doi.org/10.1186/s40635-026-00901-9
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