| Easy DAO2 index: a novel hemodynamic risk factor for predicting mortality in surgical and critically ill patients |
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Da-In Eun1,2,3,4, Hyeonhoon Lee2,5,6, Hyung-Chul Lee1,2,3 |
1Interdisciplinary Program in Medical Informatics, Seoul National University, Seoul, Republic of Korea
2Healthcare AI Research Institute, Seoul National University Hospital, Seoul, South Korea
3Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
4Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
5Department of Transdisciplinary Medicine, Seoul National University Hospital, Seoul, South Korea
6Department of Medicine, Seoul National University College of Medicine, Seoul, South Korea |
Corresponding author:
Hyung-Chul Lee, Tel: +82-2-2072-2467,
Email: vital@snu.ac.kr
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Received: 15 November 2025 • Revised: 30 April 2026 • Accepted: 6 May 2026 |
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| Abstract |
Background
Measurement of the arterial oxygen delivery index (DAO2I) requires substantial medical resources and invasive procedures. We proposed a novel hemodynamic parameter reflecting DAO2I, the Easy DAO2 index (EDI), and examined its association with mortality in non-cardiac surgical and critically ill patients.
Methods
We retrospectively analyzed the data of 95,115 surgical cases from an Asian hospital and 90,420 intensive care unit (ICU) admissions from multicenter hospitals in the United States. EDI was the product of pulse pressure, heart rate, hemoglobin, and peripheral oxygen saturation, divided by body surface area, measured every 5 minutes during anesthesia and hourly for 24 hours post-ICU admission. We assessed the association between 7-day in-hospital mortality and duration of exposure to EDI values below the fifth percentile levels.
Results
In non-cardiac surgical patients, mortality risk increased with duration of exposure below the low EDI threshold (adjusted odds ratio [aOR] 1.003 per minute; 95% CI 1.000–1.005). In critically ill patients, mortality risk increased with duration of exposure below the low EDI threshold (aOR 1.014 per hour; 95% CI 1.004–1.023).
Conclusions
Low EDI values were independently associated with mortality in non-cardiac surgical and critically ill patients, suggesting that EDI may be a useful hemodynamic parameter for risk assessment. |
| Key Words:
Hemodynamic monitoring; Critical care; Mean arterial pressure; Mortality; Pulse pressure; Perfusion |
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