title: Epidemiological features and risk factor analysis of children with acute lung injury.
abstract: BACKGROUND
  Acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) represents a devastating complication observed in critical care medicine. The purpose of this study is to investigate the epidemiological aspects of ALI/ARDS in pediatric intensive care unit (PICU) and risk factors of mortality.
  
  
  METHODS
  Patients with ALI/ARDS in PICU of Beijing Children's Hospital, a tertiary medical center from November 1, 2005 to October 31, 2006 were included in this prospective study. We identified the risk factors for underlying diseases and mortality during a 3-month followup using multivariate logistic regression analysis.
  
  
  RESULTS
  In 562 critically ill patients admitted to PICU of Beijing Children's Hospital, there were 15 ALI-non ARDS patients and 29 ARDS patients, resulting in an incidence of 7.8% (44/562). The mortality rate of ARDS was 24.1% (7/29) and that of ALI/ARDS was 18.2% (8/44). At a 3-month follow-up, 12 patients died after being discharged from PICU and the total mortality rate was 45.5% (20/44). ALI/ARDS patients with pulmonary disease had better outcomes than those with extra-pulmonary involvements (P<0.05). Discharge against medical advice, low PaO(2)/FiO(2) during hospital stay and high PaCO2 on PICU admission were risk factors of mortality.
  
  
  CONCLUSIONS
  ARDS has a high mortality rate in PICU, especially in those with extra-pulmonary diseases. In addition to aggressive medical management of comorbidity, lung protection and avoidance of discharge against medical advice will decrease the mortality.
authors.affiliation: Department of PICU, Beijing Children's Hospital of Capital Medical University, No. 56 Nan Li Shi Road, Beijing, 100045, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Quan
authors.initials: Q
authors.lastname: Wang
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.forename: Heng-Miao
authors.initials: HM
authors.lastname: Gao
authors.forename: Tong
authors.initials: T
authors.lastname: Zhou
authors.forename: Su-Yun
authors.initials: SY
authors.lastname: Qian
mesh_terms: D055371:Acute Lung Injury / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006776:Hospitals, Pediatric; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007362:Intensive Care Units; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology* / Q000382:microbiology / Q000401:mortality; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate