Original InvestigationsAcute respiratory distress syndrome: Resource use and outcomes in 1985 and 1995, trends in mortality and comorbidities*
Section snippets
Study population
We retrospectively studied all consecutive patients older than 16 years old that met ARDS criteria11 while admitted to the ICU during 1985 or 1995. We used the Hospital and ICU patient files, which were on paper in 1985 and on computer in 1995. Our hospital is a referral center for medical, surgical, and trauma patients and has a 38-bed adult ICU. The first group initially comprised 58 patients that developed ARDS between January 1 and December 31, 1985; the second group comprised 67 patients
Results
The two groups of ARDS patients from 1985 and 1995 were similar in their admission severity level (APACHE III and APS), age, and sex (Table 1). However, the admission diagnoses varied and there were more immunodepressed patients in 1995, with one hematologic patient in 1985 versus four in 1995, and no AIDS patients in 1985 versus five in 1995.
The proportion of trauma patients was greater in 1985 (45.2% vs. 37.7% in 1995), without reaching statistical significance. The trauma and nontrauma
Discussion
We studied two comparable populations of ARDS patients rated at the same institution but separated by 10 years. Over this period of time, ARDS patients of traumatic origin had different mortality and resource utilization characteristics, in terms of length of stay, days on mechanical ventilation or therapeutic effort (TISS-28 score), when compared with those of nontrauma origin.17, 18
The overall mortality of our series remained constant over time, at 55% and 60% in both time periods studied,
Acknowledgements
The authors wish to thank Dr. Francois Lemaire and Dr. Antonio Artigas for their suggestions and assistance in the data interpretation.
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Cited by (13)
Serial measurement of Therapeutic Intervention Scoring System-28 (TISS-28) in a surgical intensive care unit
2010, Journal of Critical CareCitation Excerpt :A simplified version was created by Miranda et al [4] using 28 items from a random sample of 10 000 records of TISS-76 and validated to distinguish between different degrees of nursing workload [4,5]; the TISS-28 has replaced the original TISS-76 in clinical practice. Several studies have assessed the use of TISS-28 in the ICU in evaluating nursing workload [4], resource use [6,7], mechanical ventilatory support [8,9], transport risks [10,11], and severity of illness and prognosis [12]. However, few studies have evaluated TISS-28 in the postoperative ICU setting [7,13,14].
Early markers of acute respiratory distress syndrome development in severe trauma patients
2006, Journal of Critical CareHigh tidal volume and positive fluid balance are associated with worse outcome in acute lung injury
2005, ChestCitation Excerpt :These data challenge the concept that sepsisper se is a leading cause of death from ARDS3,44,45 and suggest that the association between sepsis, in its severe forms, and multiple organ failure is most probably the cause. Despite increased understanding of the pathophysiology of ALI/ARDS and apparent advances in respiratory support technology, there has been no clear decrease in the mortality rate from ARDS over time.46 Mortality rates from ARDS are cited within the range of 40 to 60%.2
Management and outcomes of acute respiratory distress syndrome patients with and without comorbid conditions
2018, Intensive Care MedicinePast and present ARDS mortality rates: A systematic review
2017, Respiratory Care
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Address reprint requests to Pedro Navarrete-Navarro, MD, Critical Care and Emergency Department, Hospital Universitario Virgen de las Nieves, Hospital de Traumatologia, Carretera de Jaen s/n, 18014, Granada, Spain.