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  1. Improved survival of patients with acute respiratory distress syndrome (ARDS) : 1983-1993.

    Article - En anglais

    Objective

    - To analyze temporal trends in acute respiratory distress syndrome (ARDS) fatality rates since 1983 at one institution.

    Design

    Cohort.

    Setting

    - Intensive care units of a large county hospital.

    Patients

    - Consecutive adult patients (=18 years of age) meeting ARDS criteria were identified through daily surveillance of intensive care units (N=918 from 1983 through 1993).

    The major causes were sepsis syndrome in 37% and major trauma in 25% ; 37% had other risks.

    Sixty-five percent were male.

    The median age was 45 years (range, 18 to 92 years) ; 70% were younger than 60 years.

    Main Outcome Measure

    - Hospital mortality.

    Results

    Overall fatality rates showed no trend from 1983 to 1987, declined slightly in 1988 and 1989, and decreased to a low of 36% in 1993 (95% confidence interval, 25% to 46%). The crude rates were largely unchanged after adjustment for age, ARDS risk, and gender distribution.

    While patients both younger than 60 years and 60 years or older experienced declines in fatality rate, the larger decrease occurred in the younger cohort.

    In sepsis patients, ARDS fatality rates declined steadily, from 67% in 1990 to 40% in 1993 (95% confidence interval, 23% to 57%). The decline in sepsis-related ARDS fatality was confined largely to patients less than 60 years of age.

    Trauma patients and all other patients also experienced declines in fatality rates after 1987, although these trends were not as strong and consistent as in the sepsis population.

    Mots-clés Pascal : Appareil respiratoire pathologie, Facteur risque, Survie, Homme, Détresse respiratoire, Aigu, Unité soin intensif, Amélioration, Mortalité, Etats Unis, Amérique du Nord, Amérique

    Mots-clés Pascal anglais : Respiratory disease, Risk factor, Survival, Human, Respiratory distress, Acute, Intensive care unit, Improvement, Mortality, United States, North America, America

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 95-0191207

    Code Inist : 002B27B02. Création : 09/06/1995.