Risk factors of acute respiratory distress syndrome in sepsis caused by intra-abdominal infections: A retrospective study

Abstract

BackgroundIntra-abdominal infections are frequently associated with acute respiratory distress syndrome, which significantly affects patient prognosis. However, little is known about the specific risk factors of acute respiratory distress syndrome in sepsis caused by intra-abdominal infections. MethodsThis retrospective study included adult patients with intra-abdominal sepsis admitted to the intensive care unit of a tertiary teaching hospital in China between June 2017 and June 2022. Patients were categorized based on the presence or absence of acute respiratory distress syndrome. Data, including vital signs, laboratory values, and severity scores collected within 24 hours of sepsis diagnosis, as well as outcomes within 90 days, were analyzed. Multivariable logistic regression was used to identify independent risk factors associated with acute respiratory distress syndrome. ResultsA total of 738 patients were included, of whom 218 (29.5%) developed acute respiratory distress syndrome. Patients with acute respiratory distress syndrome were younger, had a higher body mass index and disease severity scores, and exhibited higher proportions of septic shock and hospital-acquired intra-abdominal infections. The mortalities in the intensive care unit and at 28 and 90 days were higher in the acute respiratory distress syndrome group. In the multivariate logistic regression model, age under 65 years (odds ratio [95% confidence interval]: 1.571 [1.093–2.259]), elevated body mass index (2.070 [1.382–3.101] for overweight, 6.994 [3.207–15.255]) for obesity, septic shock (2.043 [1.400–2.980]), procalcitonin (1.009 [1.004–1.015]), hospital-acquired intra-abdominal infections (2.528[1.373–4.657]), and source of intra-abdominal infections (2.170 [1.140–4.128] for biliary tract infection, 0.443 [0.217–0.904] for gastroduodenal perforation) were independently associated with acute respiratory distress syndrome. ConclusionIn patients with intra-abdominal sepsis, age under 65 years, higher body mass index and procalcitonin, septic shock, hospital-acquired intra-abdominal infections, and biliary tract infection were risk factors for acute respiratory distress syndrome.