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 Citations (Scopus)

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 2007

Fingerprint

Acute Lung Injury
Cohort Studies
Prospective Studies
Odds Ratio
Artificial Respiration
Survival
Confidence Intervals
Intensive Care Units
Comorbidity
Outcome Assessment (Health Care)
Resuscitation Orders
Mortality
Tertiary Healthcare
Mechanical Ventilators
Tertiary Care Centers
Respiratory Insufficiency
Length of Stay
Logistic Models
Regression Analysis
Research Personnel

Keywords

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

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

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

Six-month survival of patients with acute lung injury : Prospective cohort study. / Yilmaz, Murat; Iscimen, Remzi; Keegan, Mark T.; Vlahakis, Nicholas E.; Afessa, Bekele; Hubmayr, Rolf D.; Gajic, Ognjen.

In: Critical Care Medicine, Vol. 35, No. 10, 10.2007, p. 2303-2308.

Research output: Contribution to journalArticle

Yilmaz, M, Iscimen, R, Keegan, MT, Vlahakis, NE, Afessa, B, Hubmayr, RD & Gajic, O 2007, 'Six-month survival of patients with acute lung injury: Prospective cohort study', Critical Care Medicine, vol. 35, no. 10, pp. 2303-2308. https://doi.org/10.1097/01.CCM.0000284505.96481.24
Yilmaz M, Iscimen R, Keegan MT, Vlahakis NE, Afessa B, Hubmayr RD et al. Six-month survival of patients with acute lung injury: Prospective cohort study. Critical Care Medicine. 2007 Oct;35(10):2303-2308. https://doi.org/10.1097/01.CCM.0000284505.96481.24
Yilmaz, Murat ; Iscimen, Remzi ; Keegan, Mark T. ; Vlahakis, Nicholas E. ; Afessa, Bekele ; Hubmayr, Rolf D. ; Gajic, Ognjen. / Six-month survival of patients with acute lung injury : Prospective cohort study. In: Critical Care Medicine. 2007 ; Vol. 35, No. 10. pp. 2303-2308.
@article{f023a1811dcd4a1ea2069007f457784b,
title = "Six-month survival of patients with acute lung injury: Prospective cohort study",
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.",
keywords = "Acute lung injury, Cohort, Intensive care units, Outcome assessment, Risk factors prognosis",
author = "Murat Yilmaz and Remzi Iscimen and Keegan, {Mark T.} and Vlahakis, {Nicholas E.} and Bekele Afessa and Hubmayr, {Rolf D.} and Ognjen Gajic",
year = "2007",
month = "10",
doi = "10.1097/01.CCM.0000284505.96481.24",
language = "English (US)",
volume = "35",
pages = "2303--2308",
journal = "Critical Care Medicine",
issn = "0090-3493",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Six-month survival of patients with acute lung injury

T2 - Prospective cohort study

AU - Yilmaz, Murat

AU - Iscimen, Remzi

AU - Keegan, Mark T.

AU - Vlahakis, Nicholas E.

AU - Afessa, Bekele

AU - Hubmayr, Rolf D.

AU - Gajic, Ognjen

PY - 2007/10

Y1 - 2007/10

N2 - 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.

AB - 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.

KW - Acute lung injury

KW - Cohort

KW - Intensive care units

KW - Outcome assessment

KW - Risk factors prognosis

UR - http://www.scopus.com/inward/record.url?scp=34748825020&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34748825020&partnerID=8YFLogxK

U2 - 10.1097/01.CCM.0000284505.96481.24

DO - 10.1097/01.CCM.0000284505.96481.24

M3 - Article

VL - 35

SP - 2303

EP - 2308

JO - Critical Care Medicine

JF - Critical Care Medicine

SN - 0090-3493

IS - 10

ER -