Effect of age on the development of ARDS in trauma patients.
OBJECTIVE
The purpose of this study was to determine the independent effect of age on the risk of developing ARDS in patients with trauma.


METHODS
Prospective cohort study.


METHODS
Level I trauma center.


RESULTS
A total of 4,020 consecutive trauma patients who were > 12 years of age were identified through the Harborview Medical Center Trauma Registry over a 3-year period. During this time, 484 of the trauma patients (12%) developed ARDS, as identified by the Harborview Medical Center ARDS Registry. Patients who developed ARDS were, on average, older (mean [+/- SD] age, 44.0 +/- 18.8 vs 40.2 +/- 20.0 years, respectively; p < 0.0001) and had higher injury severity scores (23.7 +/- 11.3 vs 18.0 +/- 10.3, respectively; p < 0.0001) than trauma patients who did not develop ARDS. The maximum unadjusted odds ratio for developing ARDS was 2.93 (95% confidence interval, 1.91 to 4.50) for the group 60 to 69 years of age compared to the group 13 to 19 years of age. Patients aged > or = 80 years had an equal risk of developing ARDS compared to those age 13 to 19 years.


CONCLUSIONS
Age demonstrated a complex relationship with risk for ARDS development. Older patients showed increasingly higher risks for ARDS development up to 60 to 69 years of age, when the risk for ARDS declined. We concluded that older patients are at significantly greater risk of developing ARDS when compared to younger patients, while the oldest patients may be at less risk.
Johnston
Craig J
CJ
Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Washington School of Medicine, Harborview Medical Center, Seattle, WA 98104, USA.
Rubenfeld
Gordon D
GD
Hudson
Leonard D
LD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D012128:Respiratory Distress Syndrome / Q000453:epidemiology / Q000209:etiology*; D014193:Trauma Centers; D014861:Washington / Q000453:epidemiology; D014947:Wounds and Injuries / Q000145:classification / Q000150:complications*