Abstract:Objective To explore the clinical value of lung injury prediction score（LIPS） combined with red blood cell distribution width（RDW） for predicting short-term mortality in patients with acute respiratory distress syndrome（ARDS）. Methods A total of 326 ARDS patients who were hospitalized in the First Affiliated Hospital of Hebei North University from January 2018 to December 2021 were retrospectively included. According to the 28-day outcome, the patients were divided into death group（n=130,39.88%） and survival group（n=196,60.12%）. The clinical data of patients was extracted from the electronic medical record system, the risk factors of 28-day death in ARDS patients were screened by multivariate logistic regression analysis, and the clinical value of LIPS combined with RDW in predicting the death of ARDS patients was further evaluated by ROC curve analysis. Results Univariate analysis showed that the proportion of diabetes mellitus history and renal replacement therapy, RDW, C-reactive protein, APACHE Ⅱ and LIPS at admission in death group were significantly higher than those in survival group, while albumin（Alb） was lower than that in survival group（P＜0.05）. Multivariate logistic regression analysis showed that increased RDW（OR=1.486）, APACHE Ⅱ（OR=1.597）, LIPS（OR=1.711） were the independent risk factors for 28-day death in ARDS patients. ROC curve analysis showed that the AUC by LIPS combined with RDW was 0.922, with sensitivity of 90.00% and specificity of 82.65%, which were statistically higher than those detected by alone RDW,APACHEⅡand LIPS indicators and by APACHE Ⅱ combined with RDW in predicting the outcome of ARDS patients. Conclusion Elevated LIPS score and RDW are independent risk factors for mortality in ARDS patients. Combined application of LIPS and RDW can predict the 28-day all-cause death risk of ARDS patients and assist clinicians in identifing and classifying mortality predictors so as to manage the patients more efficiently.