Prognostic factors in acute respiratory distress syndrome: a retrospective multivariate analysis including prone positioning in management strategy.
OBJECTIVE
To investigate the prognostic factors in acute respiratory distress syndrome (ARDS) patients focusing on the use of prone positioning (PP).


METHODS
Retrospective study conducted in an intensive care unit of a university hospital.


METHODS
All consecutive mechanically ventilated ARDS patients surviving on day 7 after the diagnosis of ARDS.


METHODS
The study included all ARDS patients who survived more than 7 days after ARDS diagnosis between January 1995 and December 2002. Demographic and respiratory variables were collected on day 1, and the management of ARDS was analyzed during the first 7 days ( n=125). We performed a univariate analysis and a stepwise logistic regression analysis comparing survivors and nonsurvivors on day 28 and at 2 and 6 months.


RESULTS
Mortality rates on day 28 and at 2 and 6 months were 21.6%, 32%, and 44% respectively. A SAPS II score less than 49, McCabe score, and the use of PP introduced in the first 7 days of ARDS management appeared to be independently correlated with a decrease in mortality.


CONCLUSIONS
The SAPS II score, the McCabe score, and use of PP are independently correlated with the outcome in ARDS patients.
Venet
Christophe
C
Polyvalent Intensive Care Unit, Bellevue University Hospital, 42055, Saint Etienne Cedex 2, France. zeni@univ-st-etienne.fr
Guyomarc'h
Stephane
S
Pingat
Juliette
J
Michard
Christophe
C
Laporte
Silvy
S
Bertrand
Monique
M
Gery
Pierre
P
Page
Dominique
D
Vermesch
Regine
R
Bertrand
Jean Claude
JC
Zeni
Fabrice
F
D003422:Critical Care / Q000379:methods; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care; D011175:Positive-Pressure Respiration / Q000706:statistics & numerical data; D011379:Prognosis; D016684:Prone Position; D012128:Respiratory Distress Syndrome / Q000145:classification / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis