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印度北部一家重症监护病房中老年人群急性呼吸窘迫综合征的病因及预后

Etiology and Outcomes of ARDS in the Elderly Population in an Intensive Care Unit in North India.

作者信息

Sehgal Inderpaul S, Agarwal Ritesh, Dhooria Sahajal, Prasad Kuruswamy T, Muthu Valliappan, Aggarwal Ashutosh N

机构信息

Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Indian J Crit Care Med. 2021 Jun;25(6):648-654. doi: 10.5005/jp-journals-10071-23878.

Abstract

BACKGROUND

Whether age would impact the outcomes in subjects with acute respiratory distress syndrome (ARDS) remains unclear. Herein, we study the effect of age as a predictor of mortality in ARDS.

MATERIALS AND METHODS

We categorized consecutive subjects with ARDS as either ARDS (age >65 years) or ARDSnon (age ≤65 years) admitted to the respiratory intensive care unit (ICU) of a tertiary care hospital in North India between January 2007 and December 2019. We compared the baseline clinical and demographic characteristics, lung mechanics, and mortality between the two groups. We also analyzed the factors predicting ICU survival using multivariate logistic regression analysis.

RESULTS

We included 625 patients (ARDS, 140 [22.4%] and ARDS, 485 [77.6%]) with a mean (standard deviation) age (56.3% males) of 40.6 (17.8) years. The ARDS were more likely ( = 0.0001) to have the presence of any comorbid illness compared to ARDS. The elderly subjects had significantly higher pulmonary ARDS than the younger group. The severity of ARDS was however, similarly distributed between the two study arms. There were 224 (35.8%) deaths, and the mortality was significantly higher ( = 0.012) in the ARDS than the to ARDS (ARDS vs ARDS, 45 vs 33.2%). On multivariate logistic regression analysis, the baseline sequential organ failure assessment scores, presence of pulmonary ARDS, and the development of new organ dysfunction were the independent predictors of mortality.

CONCLUSION

The outcomes in subjects with ARDS are dependent on the severity of illness at admission and the etiology of ARDS rather than the age alone.

HOW TO CITE THIS ARTICLE

Sehgal IS, Agarwal R, Dhooria S, Prasad KT, Muthu V, Aggarwal AN. Etiology and Outcomes of ARDS in the Elderly Population in an Intensive Care Unit in North India. Indian J Crit Care Med 2021;25(6):648-654.

摘要

背景

年龄是否会影响急性呼吸窘迫综合征(ARDS)患者的预后仍不清楚。在此,我们研究年龄作为ARDS患者死亡率预测因素的作用。

材料与方法

我们将2007年1月至2019年12月期间入住印度北部一家三级医院呼吸重症监护病房(ICU)的连续性ARDS患者分为ARDS(年龄>65岁)或ARDSnon(年龄≤65岁)。我们比较了两组患者的基线临床和人口统计学特征、肺力学及死亡率。我们还使用多因素逻辑回归分析来分析预测ICU存活的因素。

结果

我们纳入了625例患者(ARDS组140例[22.4%],ARDSnon组485例[77.6%]),平均(标准差)年龄为40.6(17.8)岁(男性占56.3%)。与ARDSnon组相比,ARDS组更有可能(P = 0.0001)患有任何合并症。老年患者的肺部ARDS明显高于年轻组。然而,ARDS的严重程度在两个研究组之间分布相似。共有224例(35.8%)死亡,ARDS组的死亡率显著高于ARDSnon组(P = 0.012)(ARDS组与ARDSnon组分别为45%和33.2%)。多因素逻辑回归分析显示,基线序贯器官衰竭评估评分、肺部ARDS的存在以及新器官功能障碍的发生是死亡率的独立预测因素。

结论

ARDS患者的预后取决于入院时疾病的严重程度和ARDS的病因,而非仅取决于年龄。

如何引用本文

Sehgal IS, Agarwal R, Dhooria S, Prasad KT, Muthu V, Aggarwal AN. 印度北部重症监护病房老年人群ARDS的病因及预后。《印度重症医学杂志》2021;25(6):648 - 654。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0cc1/8286392/6fc99ce4a735/ijccm-25-648-g001.jpg

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