Stratified analysis of predictors of in-hospital mortality in 189 patients with ARDS

Abstract

Objective To determine the predictors of in-hospital mortality in patients with acute respiratory distress syndrome (The Berlin Definition).Methods The clinical data of 189 patients with acute respiratory distress syndrome (ARDS) from January 2000 to June 2012 were collected and analyzed.All patients were divided into mild-moderate group and severe group accord to PaO2/FiO2.Univariate and multivariate logistic regression analyses were performed to assess the association between the risk factors and the mortality.Results Of the 189 cases analyzed,age ranged from 18 to 89 years [mean age (52.9 ± 18.2) years].There are 24 patients with mild ARDS,102 patients with moderate ARDS,and 63patients with severe ARDS,the in-hospital mortality was 20.8％,45.1％ and 63.5％,respectively.Multivariate logistic regression analyses indicated that predictors of in-hospital mortality in patients with mild-moderate ARDS were APACHE Ⅱ and duration of hospital stay before ARDS onset ＞ 48 h,and predictors of in hospital mortality in patients with severe ARDS were mmunosuppression and Sequential Organ Failure Assessment scores.Conclusions Predictors of in-hospital mortality between ARDS patients with different severity may be different.For patients with mild moderate ARDS,we should pay more attention to early diagnosis and began to the corresponding treatment.Whereas for patients with severe ARDS,early detection and protection of failure organs and immunomodulating therapy may be more important. Key words: Acute respiratory distress syndrome; Prognosis; Risk factors; Regression analysis