TY - JOUR
T1 - Towards prevention of acute lung injury
T2 - Frequency and outcomes of emergency department patients at-risk - A multicenter cohort study
AU - Hou, Peter C.
AU - Elie-Turenne, Marie Carmelle
AU - Mitani, Aya
AU - Barry, Jonathan M.
AU - Kao, Erica Y.
AU - Cohen, Jason E.
AU - Frendl, Gyorgy
AU - Gajic, Ognjen
AU - Gentile, Nina T.
N1 - Funding Information:
The STAR Center provided internal funding (Dr. Frendl), research staff, and biostatistical support, Brigham and Women’s Hospital, Boston, MA. Dr. Gajic is supported in part by grants from the National Heart, Lung, and Blood Institute HL78743-01A1; National Center for Research Resources 1 KL2 RR024151. Dr. Gentile is supported in part by grants from the National Institute of Neurological Disorders and Stroke 5U10NS059039-04. The rest of the authors have no disclosures or conflict of interest.
PY - 2012/12
Y1 - 2012/12
N2 - Background: Few emergency department (ED) evaluations on acute lung injury (ALI) have been carried out; hence, we sought to describe a cohort of hospitalized ED patients at risk for ALI development. Methods: Patients presenting to the ED with at least one predisposing condition to ALI were included in this study, a subgroup analysis of a multicenter observational cohort study (USCIITG-LIPS 1). Patients who met ALI criteria within 6 h of initial ED assessment, received end-of-life care, or were readmitted during the study period were excluded. Primary outcome was frequency of ALI development; secondary outcomes were ICU and hospital mortality. Results: Twenty-two hospitals enrolled 4,361 patients who were followed from the ED to hospital discharge. ALI developed in 303 (7.0%) patients at a median onset of 2 days (IQR 2-5). Of the predisposing conditions, frequency of ALI development was highest in patients who had aortic surgery (43%) and lowest in patients with pancreatitis (2.8%). Compared to patients who did not develop ALI, those who did had higher ICU (24% vs. 3.0%, p < 0.001) and hospital (28% vs. 4.6%, p < 0.001) mortality, and longer hospital length of stay (16 vs. 5 days, p < 0.001). Among the 22 study sites, frequency of ALI development varied from less than 1% to more than 12% after adjustment for APACHE II. Conclusions: Seven percent of hospitalized ED patients with at least one predisposing condition developed ALI. The frequency of ALI development varied significantly according to predisposing conditions and across institutions. Further research is warranted to determine the factors contributing to ALI development.
AB - Background: Few emergency department (ED) evaluations on acute lung injury (ALI) have been carried out; hence, we sought to describe a cohort of hospitalized ED patients at risk for ALI development. Methods: Patients presenting to the ED with at least one predisposing condition to ALI were included in this study, a subgroup analysis of a multicenter observational cohort study (USCIITG-LIPS 1). Patients who met ALI criteria within 6 h of initial ED assessment, received end-of-life care, or were readmitted during the study period were excluded. Primary outcome was frequency of ALI development; secondary outcomes were ICU and hospital mortality. Results: Twenty-two hospitals enrolled 4,361 patients who were followed from the ED to hospital discharge. ALI developed in 303 (7.0%) patients at a median onset of 2 days (IQR 2-5). Of the predisposing conditions, frequency of ALI development was highest in patients who had aortic surgery (43%) and lowest in patients with pancreatitis (2.8%). Compared to patients who did not develop ALI, those who did had higher ICU (24% vs. 3.0%, p < 0.001) and hospital (28% vs. 4.6%, p < 0.001) mortality, and longer hospital length of stay (16 vs. 5 days, p < 0.001). Among the 22 study sites, frequency of ALI development varied from less than 1% to more than 12% after adjustment for APACHE II. Conclusions: Seven percent of hospitalized ED patients with at least one predisposing condition developed ALI. The frequency of ALI development varied significantly according to predisposing conditions and across institutions. Further research is warranted to determine the factors contributing to ALI development.
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U2 - 10.1186/1865-1380-5-22
DO - 10.1186/1865-1380-5-22
M3 - Article
AN - SCOPUS:84887015624
SN - 1865-1372
VL - 5
JO - International Journal of Emergency Medicine
JF - International Journal of Emergency Medicine
IS - 1
M1 - 22
ER -