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Intensive care medicine · Nov 2002
Acute lung injury and acute respiratory distress syndrome at the intensive care unit of a general university hospital in Brazil. An epidemiological study using the American-European Consensus Criteria.
- Léa Fialkow, Silvia Regina Rios Vieira, Andréia Kist Fernandes, Denise Rossato Silva, Mary Clarisse Bozzetti, and Acute Respiratory Distress Syndrome Research Group.
- Intensive Care Unit, Hospital de Clínicas de Porto Alegre, Department of Internal Medicine, Faculty of Medicine, Federal University of Rio Grande do Sul, Brazil. lfialkow@terra.com.br
- Intensive Care Med. 2002 Nov 1;28(11):1644-8.
ObjectivesTo determine: (1) the frequency of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS); (2) the mortality associated with these syndromes and (3) the influence of risk factors, comorbidities and organ system dysfunction in the mortality of ALI patients.DesignProspective cohort study.SettingIntensive care unit (ICU) of a general university hospital in Brazil.Patients And ParticipantsAll patients that remained in the ICU for more than 24 h were evaluated regarding the presence/development of ALI/ARDS according to the 1994 American-European Consensus Conference.InterventionsNone.Measurements And ResultsOne thousand three hundred and one patients were studied and analyzed regarding mortality, risk factors, comorbidities and organ system dysfunction(s). The frequency of ALI was 3.8% (50), of which ARDS was 2.3% (30) and ALI/non-ARDS 1.5% (20) (p=0.15). The ICU mortality of patients with ALI was 44.0%; in ALI/non-ARDS and ARDS patients it was 40.0% and 46.7%, respectively (p=0.43). The hospital mortality of ALI patients was 48.0%; in ALI/non-ARDS and ARDS patients it was 50.0% and 46.7%, respectively (p=0.21). A multivariate analysis demonstrated that renal (ICU and hospital: p=0.002) and hematological dysfunction (ICU: p=0.008; hospital: p=0.02) were independently associated with ICU and hospital mortality in ALI patients.Conclusions(1) The frequency of ALI was 3.8%, of which the frequency of ARDS was 2.3% and of ALI/non-ARDS 1.5%; (2) The ICU and hospital mortality of ALI patients was 44.0% and 48.0%, respectively; mortality rates of ARDS and ALI/non-ARDS did not differ significantly; (3) Renal and hematological dysfunction were associated with mortality in ALI patients.
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