First Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, National and Kapodistrian University of Athens Medical School, 45-47 Ipsilantou Street, 10676, Athens, Greece.
Critical Care Department, University Hospital of Larissa, University of Thessaly Faculty of Medicine, Larissa, Greece.
Intensive Care Med. 2023 Dec;49(12):1479-1488. doi: 10.1007/s00134-023-07238-x. Epub 2023 Oct 17.
There is growing interest in improving the inclusiveness of racial and ethnic minority participants in trials of acute respiratory distress syndrome (ARDS). With our study we aimed to examine temporal trends of representation and mortality of racial and ethnic minority participants in randomized controlled trials of ARDS.
We performed a secondary analysis of eight ARDS Network and PETAL Network therapeutic clinical trials, published between 2000 and 2019. We classified race/ethnicity into "White", "Black", "Hispanic", or "Other" (including Asian, American Indian or Alaskan Native, Native Hawaiian, or other Pacific Islander participants).
Of 5375 participants with ARDS, 1634 (30.4%) were Black, Hispanic, or Other race participants. Representation of racial and ethnic minority participants in trials did not change significantly over time (p = 0.257). However, among participants with moderate to severe ARDS (i.e., partial pressure of arterial oxygen to fraction of inspired oxygen ratio < 150), the difference in mortality between racial and ethnic minority participants and White participants decreased over time. In the five most recent trials, including 2923 participants with ARDS, there were no statistically significant differences in mortality between racial/ethnic groups, even after adjusting for potential confounders. In these five most recent trials, mortality was 31% for White, 31.9% for Black, 30.3% for Hispanic, and 37.1% for Other race participants (p = 0.633).
Representation of racial and ethnic minority participants in ARDS trials from North America, published between 2000 and 2019, did not change over time. Black and Hispanic participants with ARDS may have similar mortality as White participants within trials.
越来越多的人关注提高急性呼吸窘迫综合征（ARDS）试验中种族和少数民族参与者的包容性。通过我们的研究，我们旨在研究 ARDS 随机对照试验中种族和少数民族参与者的代表性和死亡率的时间趋势。
我们对 2000 年至 2019 年期间发表的八项 ARDS 网络和 PETAL 网络治疗性临床试验进行了二次分析。我们将种族/民族分为“白人”、“黑人”、“西班牙裔”或“其他”（包括亚洲人、美洲印第安人或阿拉斯加原住民、夏威夷原住民或其他太平洋岛民参与者）。
在 5375 名 ARDS 患者中，有 1634 名（30.4%）为黑人、西班牙裔或其他种族参与者。试验中种族和少数民族参与者的代表性随时间变化无显著差异（p=0.257）。然而，在中重度 ARDS 患者（即动脉血氧分压与吸入氧分数比<150）中，种族和少数民族参与者与白人参与者之间的死亡率差异随时间逐渐缩小。在最近的五项试验中，包括 2923 名 ARDS 患者，在调整了潜在混杂因素后，种族/族裔群体之间的死亡率没有统计学差异。在最近的五项试验中，白人患者的死亡率为 31%，黑人患者为 31.9%，西班牙裔患者为 30.3%，其他种族患者为 37.1%（p=0.633）。
2000 年至 2019 年期间在北美发表的 ARDS 试验中，种族和少数民族参与者的代表性随时间没有变化。ARDS 试验中，黑人和西班牙裔患者的死亡率可能与白人患者相似。
