Tuberc Respir Dis > Volume 44(1); 1997 > Article
Tuberculosis and Respiratory Diseases 1997;44(1):25-43.
DOI: https://doi.org/10.4046/trd.1997.44.1.25    Published online February 1, 1997.
The National Survey of Acute Respiratory Distress Syndrome in Korea.
Abstract
INTRODUCTION
The outocme and incidence of acute respiratory distress syndrome (ARDS) could be variable related to the varied definitions used for ARDS by researchers. The purpose of the national survey was to define the risk factors of ARDS and investigate the prognostic indicies related to mortality of ARDS in Korea according to the definition of ARDS determined by the American-European Concensus Conference on 1992 year. METHODS: A Multicenter registry of 48 University or University-affliated hospital and 18 general hospitals equipped with more than 400 patient's beds conducted over 13 months of patients with acute respiratory distress syndrome using the same registry protocol. RESULTS: 1. In the 12 months of the registry, 167 patients were enrolled at the 24 hospitals. 2. The mean age was 56.5 years (+/-17.2 years) and there was a 1.9:1 ratio of males to females. 3. Sepsis was the most common risk factors (78.1%), followed by aspiration (16.6%), trauma (11.6%), and shock (8.5%). 4. The overall mortality rate was 71.9%. The mean duration was 11 days (+/-13.1 days) from the diagnosis of ARDS to the death. Respiratory insufficiency appeared to be a major cause in 43.7% of the deaths followed by sepsis (36.1%), heart failure (7.6%) and hepatic failure (6.7%). 5. There were no significant differences in mortality hased on sex or age. No significant difference in mortality in infectious versus noninfectious causes of ARDS was found. 6. There were significant differences in the pulse rate, platelet numbers, serum albumin and glucose levels, the amounts of 24 hour urine, arterial pH, PaO2, PaCO2, SaO2, alveolar-arterial oxygen differences, PaO2/FIO2, and PEEP/FIO2 between the survivors and the deaths on study days 1 through 6 of the first week after enrollment. 7. The survivors had significantly less organ failure and lower APACHE III scores at the time of diagnosis of ARDS (p<0.05). 8. The numbers of organ failure (odd ratio 1.95, 95% confidence intervals:1.05-3.61, P=0.03) and the score of APACHE III (odd ratio 1.95, 95% confidence intervals:1.01-2.50, P=0.04) appeared to be independent risk factors of the mortality in the patients with ARDS. CONCLUSIONS: The mortality was 71.9% of total 167 patients in this investigation using the definition of American-European Consensus Conference on 1992 year, and the respiratory insufficiency was the leading cause of the death. In addition, the numbers of organ failure and the score of APACHE III at the time of diagnosis of ARDS appeared to be independent risk factors of the mortality in the patients with ARDS.


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