CLINICAL PREDICTORS OF MORTALITY IN ACUTE RESPIRATORY DISTRESS SYNDROME PATIENTS IN INTENSIVE CARE SETTINGS

Abstract

Acute Respiratory Distress Syndrome (ARDS) remains one of the leading causes of mortality among critically ill patients admitted to intensive care units (ICUs). This multi-center prospective study aimed to identify and validate clinical, physiological, and biochemical predictors of mortality in ARDS patients using a mixed-method quantitative framework. Data from 420 patients across four tertiary ICUs were analyzed using logistic regression and ROC curve modeling to determine the most significant predictors of adverse outcomes. The findings revealed that age, SOFA score, APACHE II score, and serum lactate levels were the strongest independent predictors of mortality, while PaO₂/FiO₂ ratio served as a crucial indicator of oxygenation status. Patients with severe ARDS (PaO₂/FiO₂ < 100 mmHg) exhibited a significantly higher mortality rate compared to those with moderate and mild forms. ROC analysis demonstrated excellent predictive accuracy (AUC = 0.87), confirming the robustness of the identified model. Additionally, inter-center variability highlighted differences in mortality patterns associated with institutional protocols and mechanical ventilation practices. These findings suggest that early recognition of high-risk indicators and implementation of standardized, data-driven management strategies can substantially improve survival outcomes. The study underscores the importance of integrating clinical scoring systems with biochemical markers to develop precision-based critical care models for ARDS management. Overall, this research contributes to advancing evidence-based ICU protocols and offers a validated predictive framework to enhance clinical decision-making and resource optimization in critical respiratory care.