• Journal of critical care · Aug 2021

    Acute Respiratory Distress Syndrome (ARDS) after trauma: Improving incidence, but increasing mortality.

    • George Kasotakis, Brent Stanfield, Krista Haines, Cory Vatsaas, Amy Alger, Steven N Vaslef, Kelli Brooks, and Suresh Agarwal.
    • Department of Surgery, Duke University School of Medicine, United States of America. Electronic address: george.kasotakis@duke.edu.
    • J Crit Care. 2021 Aug 1; 64: 213-218.

    PurposeAcute Respiratory Distress Syndrome (ARDS) is an infrequent, yet morbid inflammatory complication in injury victims. With the current project we sought to estimate trends in incidence, determine outcomes, and identify risk factors for ARDS and related mortality.Materials & MethodsThe national Trauma Quality Improvement Program dataset (2010-2014) was queried. Demographics, injury characteristics and outcomes were compared between patients who developed ARDS and those who did not. Logistic regression models were fitted for the development of ARDS and mortality respectively, adjusting for relevant confounders.ResultsIn the studied 808,195 TQIP patients, incidence of ARDS decreased over the study years (3-1.1%, p < 0.001), but related mortality increased (18.-21%, p = 0.001). ARDS patients spent an additional 14.7 ± 10.3 days in the hospital, 9.7 ± 7.9 in the ICU, and 6.6 ± 9.4 on mechanical ventilation (all p < 0.001). Older age, male gender, African American race increased risk for ARDS. Age, male gender, lower GCS and higher ISS also increased mortality risk among ARDS patients. Several pre-existing comorbidities including chronic alcohol use, diabetes, smoking, and respiratory disease also increased risk.ConclusionAlthough the incidence of ARDS after trauma appears to be declining, mortality is on the rise.Copyright © 2021. Published by Elsevier Inc.

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