Predictive Value of ADAMTS13 and LAR on the Prognosis of Acute Respiratory Distress Syndrome Patients Before Extracorporeal Membrane Oxygenation Initiation
CAO Genglei
KAN Yabai
FU Guowei
ZHAO Hui
ZHAO Yangchao
SUN Qianqian
LI Xingxing
ZHANG Chi
Abstract：Objective To analyze the predictive value of a disintegrin and metalloproteinase with thrombospondin type 1 motif,member 13(ADAMTS13)and lactate dehydrogenase/albumin ratio(LAR)on the prognosis of patients with acute respiratory distress syndrome(ARDS)before the initiation of extracorporeal membrane oxygenation(ECMO).Methods A total of 182 ARDS patients undergoing ECMO in the First Affiliated Hospital of Zhengzhou University from September 2020 to March 2025 were selected to detect the levels of ADAMTS13 and LAR within 24 hours after admission.According to the oxygenation index(OI),the patients were divided into three subgroups.Spearman correlation coefficient was used to analyze the correlation between ADAMTS13,LAR and the severity of ARDS.According to the survival of ARDS patients in intensive care unit within 28 days,they were divided into poor prognosis group(67 cases)and good prognosis group(115 cases).The clinical data,ADAMTS13 and LAR before ECMO initiation were compared between the two groups.Multivariate logistic regression analysis was used to analyze the influencing factors of poor prognosis in ARDS patients receiving ECMO treatment.Receiver operating characteristic(ROC)curve and relative risk were used to analyze the predictive value and early warning effect of ADAMTS13 and LAR before ECMO initiation on the prognosis of ARDS.Results The OI,mean artery pressure(MAP)and ADAMTS13 in the good prognosis group were higher than the poor prognosis group,the acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)score,sequential organ failure assessment(SOFA)score and LAR in the good prognosis group were lower than those in the poor prognosis group(P＜0.05).There were statistically significant differences in APACHE Ⅱ score,SOFA score,ADAMTS13 and LAR among patients with different degrees of ARDS(P＜0.05).APACHE Ⅱ score,ARDS severity and SOFA score were negatively correlated with ADAMTS13 and positively correlated with LAR(P＜0.05).Before and after correction of APACHE Ⅱ score,OI and SOFA score,ADAMTS13 and LAR were independent influencing factors of poor prognosis in ARDS patients(P＜0.05).The area under the curve(AUC)of ADAMTS13 and LAR in predicting the prognosis of ARDS before ECMO initiation was 0.870(95％CI:0.812-0.915).ARDS patients with low ADAMTS13 level and high LAR level had a higher risk of poor prognosis(P＜0.05).Conclusion ADAMTS13 and LAR before the initiation of ECMO are significantly correlated with the severity of ARDS patients,and are predictors of the prognosis of ARDS patients.Combined detection can provide relevant information for clinical diagnosis,treatment and prognosis improvement.
Keywords：acute respiratory distress syndromeextracorporeal membrane oxygenationa disintegrin and metalloproteinase with thrombospondin type 1 motifmember 13lactate dehydrogenase/albumin ratio
Publication Date：2026-07-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 2552-2557 )