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急性呼吸窘迫综合征:单中心基于不同定义的死亡率

Acute Respiratory Distress Syndrome: Mortality in a Single Center According to Different Definitions.

作者信息

Santa Cruz Roberto, Alvarez Lic Veronica, Heredia Roberto, Villarejo Fernando

机构信息

1 Hospital Regional Rio Gallegos, Rio Gallegos, Argentina.

2 School of Medicine, University of Magallanes, Punta Arenas, Chile.

出版信息

J Intensive Care Med. 2017 Jun;32(5):326-332. doi: 10.1177/0885066615608159. Epub 2015 Oct 5.

Abstract

BACKGROUND

Mortality in acute lung injury (ALI) remains high, with outcome data arising mostly from multicenter studies. We undertook this investigation to determine hospital mortality in patients with ALI in a single center.

METHODS

We studied patients admitted between 2005 and 2012 with ALI and acute respiratory distress syndrome (ARDS) according to the American European Consensus Conference (AECC) criteria and recorded clinical variables. Thereafter, patients were classified as subgroups according to the AECC and Berlin definition in order to compare the clinical characteristics and outcomes.

RESULTS

In the 93 patients comprising the study, hospital mortality was 38%. Mortality at 28 days was 36%. Multivariate analysis associated hospital mortality with age and Pao/Fio on day 1 ( P < .001). Differences resulted between the subgroups of AECC (ALI vs ARDS) and Berlin (mild vs moderate vs severe ARDS) in the lung injury score, Pao/Fio, Pao/Po, PaCo on day 1, and hospital mortality.

CONCLUSION

The overall hospital mortality (38%) was similar to that of other studies and according to the presence of ARDS (Pao/Fio ≤ 200), we found significant differences between ALI and ARDS (AECC) and between mild and moderate or severe ARDS (Berlin) in baseline respiratory variables and mortality.

摘要

背景

急性肺损伤(ALI)的死亡率仍然很高,其结果数据大多来自多中心研究。我们进行这项调查以确定单中心ALI患者的医院死亡率。

方法

我们研究了2005年至2012年间根据欧美共识会议(AECC)标准收治的ALI和急性呼吸窘迫综合征(ARDS)患者,并记录临床变量。此后,根据AECC和柏林定义将患者分为亚组,以比较临床特征和结果。

结果

在纳入研究的93例患者中,医院死亡率为38%。28天死亡率为36%。多变量分析显示医院死亡率与年龄及第1天的氧合指数(Pao/Fio)相关(P <.001)。AECC亚组(ALI与ARDS)和柏林亚组(轻度与中度与重度ARDS)在肺损伤评分、第1天的Pao/Fio、Pao/Po、PaCo以及医院死亡率方面存在差异。

结论

总体医院死亡率(38%)与其他研究相似,并且根据ARDS的存在情况(Pao/Fio≤200),我们发现ALI与ARDS(AECC)之间以及轻度与中度或重度ARDS(柏林)之间在基线呼吸变量和死亡率方面存在显著差异。

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