Six-month survival of patients with acute lung injury: Prospective cohort study

Murat Yilmaz, Remzi Iscimen, Mark T. Keegan, Nicholas E. Vlahakis, Bekele Afessa, Rolf D. Hubmayr, Ognjen Gajic

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

OBJECTIVE: Both short- and long-term outcome studies in acute lung injury (ALI) performed thus far were conducted before the implementation of recent advances in mechanical ventilation and supportive care and/or in the context of clinical trials with restricted inclusion criteria. We sought to determine the outcome of consecutive acute lung injury patients after the implementation of these interventions. DESIGN: Prospective cohort study. SETTING: Three intensive care units of two tertiary care hospitals. PATIENTS: Patients with acute lung injury treated from October 2005 to May 2006, excluding those with no research authorization or do-not-resuscitate order. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The investigators collected detailed information about comorbidities, severity of pulmonary and nonpulmonary organ failures, complications, respiratory support, and other interventions. The main outcome measure was mortality 6 months after the onset of acute lung injury. From 142 patients enrolled over a 6-month period, 24 (17%) died in the intensive care unit, 38 (27%) in the hospital, and 55 (39%) by the end of the 6-month follow-up. Median (interquartile range) intensive care unit length of stay, duration of mechanical ventilation, and number of day 28 ventilator-free days were 7.1 (3.6-11.3), 5.7 (2.6-10.3), and, 19.0 (0-24.2) days. Multiple logistic regression analysis identified underlying Charlson comorbidity score (odds ratio 3.11, 95% confidence interval 2.01-5.05) for each point increase, transfer admission from the floor or outside hospital (odds ratio 3.75, 95% confidence interval 1.41-10.99), day 3 cardiovascular failure (odds ratio 3.30, 95% confidence interval 1.19-9.92), and day 3 Pao2/Fio2 (odds ratio 0.94, 95% confidence interval 0.88-0.99) as significant predictors of 6-month mortality. CONCLUSIONS: With the implementation of recent advances in mechanical ventilation and supportive care, premorbid condition is the most important determinant of acute lung injury survival.

Original languageEnglish (US)
Pages (from-to)2303-2308
Number of pages6
JournalCritical care medicine
Volume35
Issue number10
DOIs
StatePublished - Oct 1 2007

Keywords

  • Acute lung injury
  • Cohort
  • Intensive care units
  • Outcome assessment
  • Risk factors prognosis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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    Yilmaz, M., Iscimen, R., Keegan, M. T., Vlahakis, N. E., Afessa, B., Hubmayr, R. D., & Gajic, O. (2007). Six-month survival of patients with acute lung injury: Prospective cohort study. Critical care medicine, 35(10), 2303-2308. https://doi.org/10.1097/01.CCM.0000284505.96481.24