Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea.
Yonsei Med J. 2022 May;63(5):452-460. doi: 10.3349/ymj.2022.63.5.452.
Despite recent advances in the understanding and management of acute respiratory distress syndrome (ARDS), trends in treatment, mortality, and healthcare costs following these advancements remain to be identified. In the present study, we aimed to investigate these trends using real-world data from a national cohort database in South Korea.
Using the National Health Insurance Service database, we collected and analyzed data for critically ill adult patients with ARDS who were admitted to intensive care units in South Korea between 2010 and 2019.
The final analysis included 25431 patients with ARDS. The 30-, 90-, and 365-day mortality rates in 2010 were 43.8%, 56.5%, and 68.2%, respectively. These rates had gradually decreased to 36.6%, 50.2%, and 58.8%, respectively, by 2019. Extracorporeal membrane oxygenation support for patients with ARDS started in 2014 at a rate of 5.1% (118/2309), which gradually increased to 8.3% (213/2568) by 2019. The rate of neuromuscular blockade treatment gradually increased from 22.6% (626/2771) in 2010 to 30.9% (793/2568) in 2019. The renal replacement therapy rate gradually increased from 5.7% (157/2771) in 2010 to 12.0% (307/2568) in 2019. The mean total cost of hospitalization increased from 5986.7 USD in 2010 to 12336.4 USD in 2019.
Real-world data for 2010-2019 indicate that patients with ARDS in South Korea have experienced changes in mortality, treatment, and healthcare costs. Despite the increased financial burden, mortality among patients with ARDS has decreased due to advances in disease management.
尽管人们对急性呼吸窘迫综合征（ARDS）的认识和管理有了新的进展，但在这些进展之后，治疗趋势、死亡率和医疗保健成本的趋势仍有待确定。在本研究中，我们旨在使用来自韩国国家队列数据库的真实世界数据来研究这些趋势。
使用国家健康保险服务数据库，我们收集并分析了 2010 年至 2019 年间在韩国重症监护病房入住的 ARDS 重症成年患者的数据。
最终分析纳入了 25431 例 ARDS 患者。2010 年的 30 天、90 天和 365 天死亡率分别为 43.8%、56.5%和 68.2%。到 2019 年，这些比率分别逐渐下降至 36.6%、50.2%和 58.8%。ARDS 患者的体外膜氧合支持于 2014 年以 5.1%（118/2309）的速度开始，到 2019 年逐渐增加至 8.3%（213/2568）。神经肌肉阻滞剂治疗的比率从 2010 年的 22.6%（626/2771）逐渐增加到 2019 年的 30.9%（793/2568）。肾脏替代治疗的比率从 2010 年的 5.7%（157/2771）逐渐增加到 2019 年的 12.0%（307/2568）。住院总费用从 2010 年的 5986.7 美元增加到 2019 年的 12336.4 美元。
2010-2019 年的真实世界数据表明，韩国的 ARDS 患者的死亡率、治疗和医疗保健成本发生了变化。尽管财务负担增加，但由于疾病管理的进步，ARDS 患者的死亡率有所下降。
