Assessment of factors predicting outcome of acute respiratory distress syndrome in North India.
OBJECTIVE
Information on the spectrum and outcome of acute respiratory distress syndrome (ARDS) in tropical countries is scanty. This study was designed to assess the factors predicting the outcome of ARDS in North India.


METHODS
Consecutive patients requiring mechanical ventilation for ARDS over a 2 year period at the Respiratory Intensive Care Unit (RICU) of a tertiary referral hospital were studied. Hospital survival was correlated with age, aetiology, disease severity scores (APACHE III, SAPS II, lung injury score) and organ failure using univariate analysis. Factors significantly influencing mortality were examined by multivariate analysis to identify factors independently affecting outcome.


RESULTS
Sepsis (28.6%), followed by malaria (21.4%), were the commonest risk factors. Seven out of eight patients (87.5%) with sepsis died. The presence of sepsis, more than three organ failure prior to admission, APACHE III score > 57 and SAPS II score > 39 were significantly associated with mortality. Only APACHE III score > 57 or SAPS II score > 39 were, however, independently predictive of a poor outcome following multivariate analysis.


CONCLUSIONS
Sepsis, associated with a very poor outcome, and malaria were important risk factors for the development of ARDS. APACHE III score > 57 or SAPS II score > 39 were associated with increased risk of mortality.
Gupta
D
D
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Ramanathan
R P
RP
Aggarwal
A N
AN
Jindal
S K
SK
D018806:APACHE; D000328:Adult; D015984:Causality; D005163:Factor Analysis, Statistical; D005260:Female; D006760:Hospitalization; D006801:Humans; D007194:India / Q000453:epidemiology; D007362:Intensive Care Units; D008288:Malaria / Q000150:complications / Q000453:epidemiology; D008297:Male; D017063:Outcome Assessment, Health Care; D012121:Respiration, Artificial / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000453:epidemiology* / Q000401:mortality; D012307:Risk Factors; D018805:Sepsis / Q000150:complications / Q000453:epidemiology; D016019:Survival Analysis