TY - JOUR
T1 - Eight-year trend of acute respiratory distress syndrome
T2 - A population-based study in Olmsted County, Minnesota
AU - Li, Guangxi
AU - Malinchoc, Michael
AU - Cartin-Ceba, Rodrigo
AU - Venkata, Chakradhar V.
AU - Kor, Daryl J.
AU - Peters, Steve G.
AU - Hubmayr, Rolf D.
AU - Gajic, Ognjen
PY - 2011/1/1
Y1 - 2011/1/1
N2 - Rationale: Significant progress has been made in understanding the pathogenesis of acute respiratory distress syndrome (ARDS). Recent advances in hospital practice may have reduced the incidence of this lethal syndrome. Objectives: To observe incidence trends and associated outcomes of ARDS. Methods: This population-based cohort study was conducted in Olmsted County, Minnesota. Using a validated screening protocol, investigators identified intensive care patients with acute hypoxemia and bilateral pulmonary infiltrates. The presence of ARDS was independently confirmed according to American-European Consensus Conference criteria. The incidence of ARDS and associated outcomes were comparedover the 8-year study period (2001-2008). Measurements and Main Results: Over the 8-year period, critically ill Olmsted County residents presented with increasing severity of acute illness, a greater number of comorbidities, and a higher prevalence of major predisposing conditions for ARDS. The ARDS incidence decreased significantly from 82.4 to 38.9 per 100,000 person-years during the study period (P<0.001). A decline in hospital-acquired ARDS (P<0.001) was responsible for the fall in the incidence density with no change on admission (P=0.877). Overall, mortality and hospital and intensive care unit lengths of stay decreased over time (P<0.001), whereas the ARDS case-fatality did not change significantly. Conclusions: Despite an increase in patients' severity of illness, number of comorbidities, and prevalence of major ARDS risk factors, the incidence of ARDS in this suburban community decreased by more than half. Correlation of the observed findingswith changes in health care delivery may have important implications for the planning of acute care services in other regions.
AB - Rationale: Significant progress has been made in understanding the pathogenesis of acute respiratory distress syndrome (ARDS). Recent advances in hospital practice may have reduced the incidence of this lethal syndrome. Objectives: To observe incidence trends and associated outcomes of ARDS. Methods: This population-based cohort study was conducted in Olmsted County, Minnesota. Using a validated screening protocol, investigators identified intensive care patients with acute hypoxemia and bilateral pulmonary infiltrates. The presence of ARDS was independently confirmed according to American-European Consensus Conference criteria. The incidence of ARDS and associated outcomes were comparedover the 8-year study period (2001-2008). Measurements and Main Results: Over the 8-year period, critically ill Olmsted County residents presented with increasing severity of acute illness, a greater number of comorbidities, and a higher prevalence of major predisposing conditions for ARDS. The ARDS incidence decreased significantly from 82.4 to 38.9 per 100,000 person-years during the study period (P<0.001). A decline in hospital-acquired ARDS (P<0.001) was responsible for the fall in the incidence density with no change on admission (P=0.877). Overall, mortality and hospital and intensive care unit lengths of stay decreased over time (P<0.001), whereas the ARDS case-fatality did not change significantly. Conclusions: Despite an increase in patients' severity of illness, number of comorbidities, and prevalence of major ARDS risk factors, the incidence of ARDS in this suburban community decreased by more than half. Correlation of the observed findingswith changes in health care delivery may have important implications for the planning of acute care services in other regions.
KW - Acute respiratory distress syndrome
KW - Epidemiology
KW - Incidence
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U2 - 10.1164/rccm.201003-0436OC
DO - 10.1164/rccm.201003-0436OC
M3 - Article
C2 - 20693377
AN - SCOPUS:78650780266
SN - 1073-449X
VL - 183
SP - 59
EP - 66
JO - American journal of respiratory and critical care medicine
JF - American journal of respiratory and critical care medicine
IS - 1
ER -