The association between prehospital vulnerability, ards development, and mortality among at-risk adults results from the lips-a clinical trial

Aluko A. Hope, Jen Ting Chen, David A. Kaufman, Daniel S. Talmor, Daryl J. Kor, Ognjen Gajic, Michelle N. Gong

Research output: Contribution to journalArticle

Abstract

Rationale: No previous studies have examined the role of prehospital vulnerability in acute respiratory distress syndrome (ARDS) development and mortality in an acutely ill adult population. Objectives: To describe the association between prehospital vulnerability and 1) the development of ARDS, 2) 28-day mortality, and 3) 1-year mortality. Methods: This was a longitudinal prospective cohort study nested within the multicenter LIPS-A (Lung Injury Prevention Study-Aspirin) trial. We analyzed 301 participants who completed Vulnerable Elders Survey (VES) at baseline. Multivariable logistic regression and Cox regression analyses were used to describe the association between vulnerability and short-term outcomes (ARDS and 28-day mortality) and long-term outcomes (1-year mortality), respectively. Results: The VES score ranged from 0 to 10 (median [interquartile range], 2.0 [0-6]); 143 (47.5%) fit criteria for prehospital vulnerability (VES>3). Vulnerability was not significantly associated with ARDS development (10 [7.0%] vulnerable patients developed ARDS as per LIPS-A study criteria vs. 20 [12.7%] without vulnerability; P=0.10; adjusted odds ratio [95% confidence interval (CI)], 0.54 [0.24-1.24]; P = 0.15). Nor was vulnerability associated with 28-day mortality (15 [10.5%] vulnerable patients were dead by Day 28 vs. 11 [7.0%] nonvulnerable patients; P = 0.28; adjusted odds ratio [95% CI], 0.95 [0.39-2.26]; P = 0.90). Vulnerability was significantly associated with 1-year mortality in hospital survivors (35 [26.9%] vs. 13 [9.3%]; adjusted hazard ratio [95% CI], 2.20 [1.10-4.37]; P=0.02). Conclusions: In a population of adults recruited for their high risk of ARDS, prehospital vulnerability, measured by VES, was highly prevalent and strongly associated with 1-year mortality.

Original languageEnglish (US)
Pages (from-to)1399-1404
Number of pages6
JournalAnnals of the American Thoracic Society
Volume16
Issue number11
DOIs
StatePublished - Jan 1 2019

Fingerprint

Lip
Adult Respiratory Distress Syndrome
Clinical Trials
Mortality
Lung Injury
Confidence Intervals
Aspirin
Odds Ratio
Hospital Mortality
Population
Survivors
Cohort Studies
Logistic Models
Regression Analysis
Prospective Studies
Surveys and Questionnaires

Keywords

  • Acute respiratory distress syndrome
  • Frailty
  • Outcomes
  • Survivors

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

The association between prehospital vulnerability, ards development, and mortality among at-risk adults results from the lips-a clinical trial. / Hope, Aluko A.; Chen, Jen Ting; Kaufman, David A.; Talmor, Daniel S.; Kor, Daryl J.; Gajic, Ognjen; Gong, Michelle N.

In: Annals of the American Thoracic Society, Vol. 16, No. 11, 01.01.2019, p. 1399-1404.

Research output: Contribution to journalArticle

Hope, Aluko A. ; Chen, Jen Ting ; Kaufman, David A. ; Talmor, Daniel S. ; Kor, Daryl J. ; Gajic, Ognjen ; Gong, Michelle N. / The association between prehospital vulnerability, ards development, and mortality among at-risk adults results from the lips-a clinical trial. In: Annals of the American Thoracic Society. 2019 ; Vol. 16, No. 11. pp. 1399-1404.
@article{52738577ba654e1da3169578acfe8aaa,
title = "The association between prehospital vulnerability, ards development, and mortality among at-risk adults results from the lips-a clinical trial",
abstract = "Rationale: No previous studies have examined the role of prehospital vulnerability in acute respiratory distress syndrome (ARDS) development and mortality in an acutely ill adult population. Objectives: To describe the association between prehospital vulnerability and 1) the development of ARDS, 2) 28-day mortality, and 3) 1-year mortality. Methods: This was a longitudinal prospective cohort study nested within the multicenter LIPS-A (Lung Injury Prevention Study-Aspirin) trial. We analyzed 301 participants who completed Vulnerable Elders Survey (VES) at baseline. Multivariable logistic regression and Cox regression analyses were used to describe the association between vulnerability and short-term outcomes (ARDS and 28-day mortality) and long-term outcomes (1-year mortality), respectively. Results: The VES score ranged from 0 to 10 (median [interquartile range], 2.0 [0-6]); 143 (47.5{\%}) fit criteria for prehospital vulnerability (VES>3). Vulnerability was not significantly associated with ARDS development (10 [7.0{\%}] vulnerable patients developed ARDS as per LIPS-A study criteria vs. 20 [12.7{\%}] without vulnerability; P=0.10; adjusted odds ratio [95{\%} confidence interval (CI)], 0.54 [0.24-1.24]; P = 0.15). Nor was vulnerability associated with 28-day mortality (15 [10.5{\%}] vulnerable patients were dead by Day 28 vs. 11 [7.0{\%}] nonvulnerable patients; P = 0.28; adjusted odds ratio [95{\%} CI], 0.95 [0.39-2.26]; P = 0.90). Vulnerability was significantly associated with 1-year mortality in hospital survivors (35 [26.9{\%}] vs. 13 [9.3{\%}]; adjusted hazard ratio [95{\%} CI], 2.20 [1.10-4.37]; P=0.02). Conclusions: In a population of adults recruited for their high risk of ARDS, prehospital vulnerability, measured by VES, was highly prevalent and strongly associated with 1-year mortality.",
keywords = "Acute respiratory distress syndrome, Frailty, Outcomes, Survivors",
author = "Hope, {Aluko A.} and Chen, {Jen Ting} and Kaufman, {David A.} and Talmor, {Daniel S.} and Kor, {Daryl J.} and Ognjen Gajic and Gong, {Michelle N.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1513/AnnalsATS.201902-116OC",
language = "English (US)",
volume = "16",
pages = "1399--1404",
journal = "Annals of the American Thoracic Society",
issn = "2325-6621",
publisher = "American Thoracic Society",
number = "11",

}

TY - JOUR

T1 - The association between prehospital vulnerability, ards development, and mortality among at-risk adults results from the lips-a clinical trial

AU - Hope, Aluko A.

AU - Chen, Jen Ting

AU - Kaufman, David A.

AU - Talmor, Daniel S.

AU - Kor, Daryl J.

AU - Gajic, Ognjen

AU - Gong, Michelle N.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Rationale: No previous studies have examined the role of prehospital vulnerability in acute respiratory distress syndrome (ARDS) development and mortality in an acutely ill adult population. Objectives: To describe the association between prehospital vulnerability and 1) the development of ARDS, 2) 28-day mortality, and 3) 1-year mortality. Methods: This was a longitudinal prospective cohort study nested within the multicenter LIPS-A (Lung Injury Prevention Study-Aspirin) trial. We analyzed 301 participants who completed Vulnerable Elders Survey (VES) at baseline. Multivariable logistic regression and Cox regression analyses were used to describe the association between vulnerability and short-term outcomes (ARDS and 28-day mortality) and long-term outcomes (1-year mortality), respectively. Results: The VES score ranged from 0 to 10 (median [interquartile range], 2.0 [0-6]); 143 (47.5%) fit criteria for prehospital vulnerability (VES>3). Vulnerability was not significantly associated with ARDS development (10 [7.0%] vulnerable patients developed ARDS as per LIPS-A study criteria vs. 20 [12.7%] without vulnerability; P=0.10; adjusted odds ratio [95% confidence interval (CI)], 0.54 [0.24-1.24]; P = 0.15). Nor was vulnerability associated with 28-day mortality (15 [10.5%] vulnerable patients were dead by Day 28 vs. 11 [7.0%] nonvulnerable patients; P = 0.28; adjusted odds ratio [95% CI], 0.95 [0.39-2.26]; P = 0.90). Vulnerability was significantly associated with 1-year mortality in hospital survivors (35 [26.9%] vs. 13 [9.3%]; adjusted hazard ratio [95% CI], 2.20 [1.10-4.37]; P=0.02). Conclusions: In a population of adults recruited for their high risk of ARDS, prehospital vulnerability, measured by VES, was highly prevalent and strongly associated with 1-year mortality.

AB - Rationale: No previous studies have examined the role of prehospital vulnerability in acute respiratory distress syndrome (ARDS) development and mortality in an acutely ill adult population. Objectives: To describe the association between prehospital vulnerability and 1) the development of ARDS, 2) 28-day mortality, and 3) 1-year mortality. Methods: This was a longitudinal prospective cohort study nested within the multicenter LIPS-A (Lung Injury Prevention Study-Aspirin) trial. We analyzed 301 participants who completed Vulnerable Elders Survey (VES) at baseline. Multivariable logistic regression and Cox regression analyses were used to describe the association between vulnerability and short-term outcomes (ARDS and 28-day mortality) and long-term outcomes (1-year mortality), respectively. Results: The VES score ranged from 0 to 10 (median [interquartile range], 2.0 [0-6]); 143 (47.5%) fit criteria for prehospital vulnerability (VES>3). Vulnerability was not significantly associated with ARDS development (10 [7.0%] vulnerable patients developed ARDS as per LIPS-A study criteria vs. 20 [12.7%] without vulnerability; P=0.10; adjusted odds ratio [95% confidence interval (CI)], 0.54 [0.24-1.24]; P = 0.15). Nor was vulnerability associated with 28-day mortality (15 [10.5%] vulnerable patients were dead by Day 28 vs. 11 [7.0%] nonvulnerable patients; P = 0.28; adjusted odds ratio [95% CI], 0.95 [0.39-2.26]; P = 0.90). Vulnerability was significantly associated with 1-year mortality in hospital survivors (35 [26.9%] vs. 13 [9.3%]; adjusted hazard ratio [95% CI], 2.20 [1.10-4.37]; P=0.02). Conclusions: In a population of adults recruited for their high risk of ARDS, prehospital vulnerability, measured by VES, was highly prevalent and strongly associated with 1-year mortality.

KW - Acute respiratory distress syndrome

KW - Frailty

KW - Outcomes

KW - Survivors

UR - http://www.scopus.com/inward/record.url?scp=85074378812&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85074378812&partnerID=8YFLogxK

U2 - 10.1513/AnnalsATS.201902-116OC

DO - 10.1513/AnnalsATS.201902-116OC

M3 - Article

C2 - 31453722

AN - SCOPUS:85074378812

VL - 16

SP - 1399

EP - 1404

JO - Annals of the American Thoracic Society

JF - Annals of the American Thoracic Society

SN - 2325-6621

IS - 11

ER -