Siddiqui Shahla, Puthucheary Zudin, Phua Jason, Ho Benjamin, Tan Jonathan, Chuin Siau, Lim Noelle Louise, Soh Chai Rick, Loo Chian Min, Tan Addy Y H, Mukhopadhyay Amartya, Khan Faheem Ahmed, Johan Azman, Tan Aik Hau, MacLaren Graeme, Taculod Juvel, Ramos Blesilda, Han Tun Aung, Cove Matthew E
Khoo Teck Puat Hospital, Yishun, Singapore, Singapore.
Departments of Medicine, Anaesthesia and Surgery, National University Hospital, National University Health System, Singapore, Singapore.
PLoS One. 2017 Jun 16;12(6):e0179343. doi: 10.1371/journal.pone.0179343. eCollection 2017.
In the past 20 years, our understanding of acute respiratory distress syndrome (ARDS) management has improved, but the worldwide incidence and current outcomes are unclear. The reported incidence is highly variable, and no studies specifically characterise ARDS epidemiology in Asia. This observation study aims to determine the incidence, mortality and management practices of ARDS in a high income South East Asian country.
We conducted a prospective, population based observational study in 6 public hospitals. During a one month period, we identified all ARDS patients admitted to public hospital intensive care units (ICU) in Singapore, according to the Berlin definition. Demographic information, clinical management data and ICU outcome data was collected.
A total of 904 adult patients were admitted to ICU during the study period and 15 patients met ARDS criteria. The unadjusted incidence of ARDS was 4.5 cases per 100,000 population, accounting for 1.25% of all ICU patients. Most patients were male (75%), Chinese (62%), had pneumonia (73%), and were admitted to a Medical ICU (56%). Management strategies varied across all ICUs. In-hospital mortality was 40% and median length of ICU stay was 7 days.
The incidence of ARDS in a developed S.E Asia country is comparable to reported rates in European studies.
在过去20年里，我们对急性呼吸窘迫综合征（ARDS）治疗的认识有所提高，但全球发病率和当前治疗结果尚不清楚。报道的发病率差异很大，且没有研究专门描述亚洲ARDS的流行病学特征。这项观察性研究旨在确定一个高收入东南亚国家ARDS的发病率、死亡率及治疗方法。
我们在6家公立医院开展了一项基于人群的前瞻性观察性研究。在为期1个月的时间里，我们根据柏林定义确定了所有入住新加坡公立医院重症监护病房（ICU）的ARDS患者。收集了人口统计学信息、临床治疗数据及ICU治疗结果数据。
研究期间共有904名成年患者入住ICU，其中15名患者符合ARDS标准。ARDS的未经调整发病率为每10万人口4.5例，占所有ICU患者的1.25%。大多数患者为男性（75%）、华裔（62%），患有肺炎（73%），并入住内科ICU（56%）。所有ICU的治疗策略各不相同。住院死亡率为40%，ICU住院时间中位数为7天。
一个东南亚发达国家的ARDS发病率与欧洲研究报道的发病率相当。
