title: Acute respiratory failure in Pakistani patients: risk factors associated with mortality.
abstract: OBJECTIVE
  To assess the outcome and risk factors associated with mortality in patients with acute respiratory failure (ARF).
  
  
  METHODS
  Observational study.
  
  
  METHODS
  The Aga Khan University Hospital, Karachi, between January 1997 and June 2001.
  
  
  METHODS
  All adult patients admitted with a medical cause of acute respiratory failure were reviewed. The primary outcome measure was mortality and secondary outcome measures were factors associated with mortality in ARF. Multiple logistic regression analysis was used to identify the independent risk factors for mortality.
  
  
  RESULTS
  A total of 270 patients were admitted with ARF. Hypercapnic respiratory failure was seen in 186 (69%) and hypoxemic in 84 (31%) cases. Pneumonia and COPD exacerbation were the most common underlying causes of ARF. Ventilator support was required in 93 (34.4%) patients. Hospital mortality was 28%. Chronic renal failure, malignancy, hypokalemia, severe acidosis (pH <7.25) septicemia and ARDS independently correlated with mortality. Mortality rate increased sharply (84%) with the presence of three or more risk factors.
  
  
  CONCLUSIONS
  Acute respiratory failure has a high mortality rate (28%). Development of ARDS or septicemia was associated with high mortality. Presence of more than one risk factor significantly increased the mortality rate.
authors.affiliation: Section of Pulmonary and Critical Medicine, The Aga Khan University Hospital, P.O. Box 3500, Stadium Road, Karachi 74800, Pakistan. fayyaz.hussain@aku.edu
authors.forename: Syed Fayyaz
authors.initials: SF
authors.lastname: Hussain
authors.forename: Muhammad
authors.initials: M
authors.lastname: Irfan
authors.forename: Yawar Saeed
authors.initials: YS
authors.lastname: Naqi
authors.forename: Muhammad
authors.initials: M
authors.lastname: Islam
authors.forename: Waseem
authors.initials: W
authors.lastname: Akhtar
mesh_terms: D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002423:Cause of Death; D003906:Developing Countries; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010154:Pakistan / Q000453:epidemiology; D011336:Probability; D012129:Respiratory Function Tests; D012131:Respiratory Insufficiency / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate