法国急性呼吸窘迫综合征的全国发病率和相关死亡率。
National incidence rate and related mortality for acute respiratory distress syndrome in France.
机构信息
Assistance Publique - Hôpitaux de Marseille, Hôpital Nord, Médecine Intensive Réanimation, 13015 Marseille, France; Aix-Marseille Université, Faculté de Médecine, Centre d'Études et de Recherches sur les Services de Santé et qualité de vie EA 3279, 13005 Marseille, France.
Aix-Marseille Université, Faculté de Médecine, Centre d'Études et de Recherches sur les Services de Santé et qualité de vie EA 3279, 13005 Marseille, France; Unité d'Aide Méthodologique à la Recherche Clinique, Assistance Publique, Hôpitaux de Marseille, 13015 Marseille, France.
出版信息
Anaesth Crit Care Pain Med. 2021 Feb;40(1):100795. doi: 10.1016/j.accpm.2020.100795. Epub 2020 Dec 24.
INTRODUCTION
Despite many efforts to improve mechanical ventilation strategies and the use of rescue strategies, ARDS-related mortality remains high. The primary objective of this study was to determine the incidence and 90-day mortality of ARDS patients admitted to all French ICUs following the introduction of the Berlin definition of ARDS.
PATIENTS AND METHODS
The data source for this nationwide cohort study was the French national hospital database (Programme de Médicalisation des Systèmes d'Information (PMSI)), which systematically collects administrative and medical information related to all patients hospitalised and hospital stays. Patient-level data were obtained from the PMSI database for all patients admitted to an ICU from the 1 of January 2017, through the 31 of December 2017. The inclusion criteria were as follows: ICU patients ≥ 18 years old with at least one International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10) diagnosis code of J80 (ARDS), either as a primary diagnosis or a secondary diagnosis, during their ICU stay.
RESULTS
A total of 12,846 ICU adult patients with ARDS were included. The crude incidence of ARDS was 24.6 per 100,000 person-years, varying with age from 6.7 per 100,000 person-years for those 18 through 40 years of age to 51.9 per 100,000 person-years for those 68 through 76 years of age. The in-hospital mortality rate was 51.1%. Day-90 mortality (day-1 being the ICU admission) was 51.2% and increased with age from 29.0% for patients 18 through 40 years of age to 69.3% for patients 77 years of age or older (p < 0.001). Only 53.9% of the survivors were transferred home directly after hospital discharge.
CONCLUSIONS
The incidence and mortality of ARDS in adults in France are higher than that generally reported in other countries.
引言
尽管人们为改进机械通气策略和使用抢救策略做出了诸多努力，急性呼吸窘迫综合征（ARDS）相关死亡率仍然居高不下。本研究的主要目的是确定在引入 ARDS 的柏林定义后，所有法国重症监护病房（ICU）收治的 ARDS 患者的发病率和 90 天死亡率。
患者和方法
本全国性队列研究的数据来源是法国国家医院数据库（Programme de Médicalisation des Systèmes d'Information (PMSI)），该数据库系统地收集与所有住院患者和住院时间相关的行政和医疗信息。从 2017 年 1 月 1 日至 2017 年 12 月 31 日，从 PMSI 数据库中获取所有 ICU 患者的数据，纳入标准为：年龄≥18 岁的 ICU 患者，至少有一个国际疾病分类，第十次修订版，临床修正（ICD-10）J80（ARDS）诊断代码，无论是主要诊断还是次要诊断，在 ICU 住院期间。
结果
共纳入 12846 例成人 ICU ARDS 患者。ARDS 的粗发病率为 24.6/10 万人年，年龄从 18 至 40 岁的 6.7/10 万人年到 68 至 76 岁的 51.9/10 万人年不等。院内死亡率为 51.1%。（第 1 天为 ICU 入院）90 天死亡率为 51.2%，并随年龄增长而增加，从 18 至 40 岁患者的 29.0%到 77 岁或以上患者的 69.3%（p<0.001）。出院后直接回家的幸存者仅占 53.9%。
结论
法国成年人 ARDS 的发病率和死亡率高于其他国家的一般报告。
Zotero 插件