8. Factors relating to mortality in patients with acute respiratory distress syndrome due to pneumonia

Luong Quoc Chinh, Pham Thi Quynh

Main Article Content

Abstract

This retrospective cross-sectional observational study aimed to evaluate factors associated with intensive care unit (ICU) mortality in patients with acute respiratory distress syndrome due to pneumonia at Bach Mai Hospital between August 2018 and August 2022. Of 105 patients, 66.7% (70/105) were men, and the median age was 62.0 (Q1 - Q2: 48.5 - 72.5) years. On admission, most patients had moderate (35.2%; 37/105) and severe (54.3%; 57/105) hypoxemia according to the Berlin criteria, and respiratory viruses (31.7%; 26/82) were the most common pathogens of pneumonia. The all-cause ICU mortality rate was 69.5% (73/105). Multivariable logistic regression analysis shows that endotracheal intubation in lower-level hospitals or on the way to a central hospital (adjusted odds ratio/AOR: 0.156; 95%CI: 0.029 - 0.841; p < 0.001) and septic shock (AOR: 15.882; 95%CI: 2.426 - 103.992; p = 0.004) were independently associated with ICU mortality in patients with ARDS due to pneumonia.

Article Details

References

1. Bellani G, Laffey JG, Pham T, et al. Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries. Jama. 2016;315(8):788-800.
2. Chinh LQ, Manabe T, Son DN, et al. Clinical epidemiology and mortality on patients with acute respiratory distress syndrome (ARDS) in Vietnam. PloS one. 2019;14(8):e0221114-e0221114.
3. Villar J, Pérez-Méndez L, Basaldúa S, et al. A risk tertiles model for predicting mortality in patients with acute respiratory distress syndrome: age, plateau pressure, and P(aO(2))/F(IO(2)) at ARDS onset can predict mortality. Respiratory care. 2011;56(4):420-428.
4. Laffey JG, Madotto F, Bellani G, et al. Geo-economic variations in epidemiology, patterns of care, and outcomes in patients with acute respiratory distress syndrome: insights from the LUNG SAFE prospective cohort study. The Lancet Respiratory medicine. 2017;5(8):627-638.
5. World Health Organization. The 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11). The World Health Organization. Classification of Diseases (ICD) Web site. http://www.who.int/classifications/icd/en/. Published 2019. Updated May 2019. Accessed June 15, 2021.
6. ARDS Definition Task Force, Ranieri VM, Rubenfeld GD, et al. Acute respiratory distress syndrome: The Berlin Definition. Jama. 2012;307(23):2526-2533.
7. Kalil AC, Metersky ML, Klompas M, et al. Management of Adults With Hospital-acquired and Ventilator-associated Pneumonia: 2016 Clinical Practice Guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2016;63(5):e61-e111.
8. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). Jama. 2016;315(8):801-810.
9. Makris K, Spanou L. Acute Kidney Injury: Definition, Pathophysiology and Clinical Phenotypes. The Clinical biochemist Reviews. 2016;37(2):85-98.
10. Sheu CC, Gong MN, Zhai R, et al. Clinical characteristics and outcomes of sepsis-related vs non-sepsis-related ARDS. Chest. 2010;138(3):559-567.
11. Sevransky JE, Martin GS, Mendez-Tellez P, et al. Pulmonary vs nonpulmonary sepsis and mortality in acute lung injury. Chest. 2008;134(3):534-538.
12. Jain S, Self WH, Wunderink RG, et al. Community-Acquired Pneumonia Requiring Hospitalization among U.S. Adults. The New England journal of medicine. 2015;373(5):415-427.
13. Choi SH, Hong SB, Ko GB, et al. Viral infection in patients with severe pneumonia requiring intensive care unit admission. American journal of respiratory and critical care medicine. 2012;186(4):325-332.
14. Kao KC, Hu HC, Hsieh MJ, et al. Comparison of community-acquired, hospital-acquired, and intensive care unit-acquired acute respiratory distress syndrome: A prospective observational cohort study. Critical care (London, England). 2015;19:384.
15. Ellison RT, Donowitz GR. 69 - Acute Pneumonia. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases (Eighth Edition). Philadelphia: W.B. Saunders; 2015:823-846.e825.