title: A 12-month clinical survey of incidence and outcome of acute respiratory distress syndrome in Shanghai intensive care units.
abstract: OBJECTIVE
  To investigate incidence, causes, and outcome of acute respiratory distress syndrome (ARDS) in adult patients admitted to intensive care units (ICU) in Shanghai.
  
  
  METHODS
  A prospective 12-month survey during 2001-2002 of the predispositions, clinical management strategies, complications, and 90-day survival rates of patients with ARDS.
  
  
  METHODS
  Fifteen ICU in 12 university hospitals in Shanghai. All ICU admissions >/=15 years of age in the 12-month period were assessed. Patients fulfilling diagnostic criteria of ARDS, as defined by the American-European Consensus Conference, and having a continuous treatment period >/=24 h, were recruited.
  
  
  RESULTS
  Of 5320 adult patients admitted to ICUs, there were 108 (2%) with ARDS. At inclusion, ARDS patients had a mean PaO(2)/FiO(2) value of 111.3+/-40.3 mmHg and a mean acute physiology and chronic health evaluation score (APACHE II) of 17.3+/-8.0; 33 patients had a lung injury score >2.5. Forty-one and 67 patients had ARDS associated with diseases of pulmonary and extrapulmonary origin, respectively. The most common predisposing factors for ARDS were pneumonia (34.3%) and nonpulmonary sepsis (30.6%). The overall ICU mortality was 10.3%. In-hospital and 90-day mortalities of ARDS patients were 68.5 and 70.4%, respectively, and accounted for 13.5% of the overall ICU mortality. For ARDS patients, multiple organ dysfunction syndrome was a major risk factor associated with death (59.5%).
  
  
  CONCLUSIONS
  The high morbidity and mortality of ARDS in the ICUs in Shanghai require reassessment of respiratory and intensive care management and implementation of effective therapeutic interventions.
authors.affiliation: Laboratory of Respiratory and Intensive Care Medicine, Children's Hospital of Fudan University, 183 Feng Lin Road, 200032 Shanghai, China.
authors.forename: Yueming
authors.initials: Y
authors.lastname: Lu
authors.forename: Zhifang
authors.initials: Z
authors.lastname: Song
authors.forename: Xin
authors.initials: X
authors.lastname: Zhou
authors.forename: Shaoguang
authors.initials: S
authors.lastname: Huang
authors.forename: Duming
authors.initials: D
authors.lastname: Zhu
authors.forename: Xingyi
authors.initials: X
authors.lastname: Yang C Bai
authors.forename: Bo
authors.initials: B
authors.lastname: Sun
authors.forename: Roger
authors.initials: R
authors.lastname: Spragg
mesh_terms: D018806:APACHE; D002423:Cause of Death; D002681:China / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D012307:Risk Factors; D016896:Treatment Outcome