ArticleActa anaesthesiologica Scandinavica2026
Optimal Cutoffs for the Ratio of Arterial Oxygen Partial Pressure to Inspired Oxygen Fraction in Categorizing Respiratory Impairment Severity in Organ Failure Scores.
Article in Acta anaesthesiologica Scandinavica, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Performance of sequential organ failure assessment 1 versus 2 for sepsis identification in patients with suspected infection: a multicenter retrospective cohort study.Critical care (London, England) · 2026Article
- Optimal Cutoffs for the Ratio of Arterial Oxygen Partial Pressure to Inspired Oxygen Fraction in Categorizing Respiratory Impairment Severity in Organ Failure Scores.Acta anaesthesiologica Scandinavica · 2026Article
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14 authors.
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Abstract
backgroundThe ratio of arterial oxygen partial pressure to fraction of inspired oxygen (PaO
methodsWe used the database of the intensive care unit of Kuopio University Hospital, Finland, for cutoff derivation and the eICU database, a multicenter U.S. intensive care registry, for external validation. We identified cutoffs most discriminative for hospital mortality using the log-rank statistic test with the Contal and O'Quigley method. In external validation, these cutoffs were compared with those in the current respiratory SOFA score.
resultsOptimal cutoffs were identified as follows: P/F ratio > 40 kPa (normal), 30-40 kPa (mild impairment), 20-30 kPa (moderate impairment), 10-20 kPa (severe impairment), and ≤ 10 kPa (critical impairment). These cutoffs resulted in clear separation of the severity categories (chi-square for log-rank statistic 356.9). They outperformed the current respiratory SOFA score cutoffs in the validation cohort (AUROC 0.615, 95% CI 0.607-0.622 vs. AUROC 0.610, 95% CI 0.603-0.618, p < 0.001). Advanced respiratory support was associated with higher mortality, but its inclusion as a prerequisite improved discrimination only in the moderately impaired respiratory function category, not in the severely or critically impaired categories.
conclusionP/F ratio cutoffs using 10 kPa (75 mmHg) intervals were identified to be optimal for distinguishing stages of respiratory failure severity. The impact of respiratory support on P/F ratio-mortality associations suggests the need to calibrate any P/F ratio-based score by support level, but optimal calibration methods require further study. EDITORIAL COMMENT: In this study, the cut-off values for the partial pressure of arterial oxygen to the fraction of inspired oxygen (P/F ratio) were investigated in a large Finnish intensive care database and validated externally with the US intensive care registry. The aim was to support a revision of the cut-off values for the P/F ratio in the Sequential Organ Failure Assessment (SOFA) score. The results showed that incremental changes in the P/F ratio of 10 kPa are better than 13 kPa and emphasize the need for critical assessment of the current SOFA score.
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