Incidence and mortality of adult respiratory distress syndrome: a prospective analysis from a large metropolitan hospital.
We examined the incidence and mortality of adult respiratory distress syndrome (ARDS) in patients receiving emergency medical care at a large metropolitan medical center. The patients were classified into eight high-risk categories and monitored prospectively until discharge or death. Over a period of 12 months, 11,112 such patients entered the emergency room. Of 4926 who were admitted to the hospital acutely ill, 90 (2%) developed ARDS. Thirty-six percent of these survived. ARDS occurred in 25% of patients admitted with acquired immune deficiency syndrome and Pneumocystis carinii pneumonia, and mortality in these patients was 86%. Aspiration pneumonia was the primary cause of ARDS in 37% of the patients, who also had a similar mortality rate (85%). Mortality was also high in patients with multisystem organ failure or with ARDS and disseminated intravascular coagulation. These results indicate that there probably is a relatively low incidence of ARDS among hospital patients admitted with high-risk diagnoses.
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D000368:Aged; D002140:California; D004211:Disseminated Intravascular Coagulation / Q000150:complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000150:complications; D011020:Pneumonia, Pneumocystis / Q000150:complications; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality