title: Trends in the incidence of noncardiogenic acute respiratory failure: the role of race.
abstract: OBJECTIVE
  We sought to examine trends in the race-specific incidence of acute respiratory failure in the United States.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  We used the National Hospital Discharge Survey database (1992-2007), an annual survey of approximately 500 hospitals weighted to provide national hospitalization estimates.
  
  
  METHODS
  All incident cases of noncardiogenic acute respiratory failure hospitalized in the United States.
  
  
  METHODS
  None.
  
  
  RESULTS
  We identified noncardiogenic acute respiratory failure by the presence of International Classification of Diseases, Ninth Revision, codes for respiratory failure or pulmonary edema (518.4, 518.5, 518.81, and 518.82) and mechanical ventilation (96.7×), excluding congestive heart failure. Incidence rates were calculated using yearly census estimates standardized to the age and sex distribution of the 2000 census population. Annual cases of noncardiogenic acute respiratory failure increased from 86,755 in 1992 to 323,474 in 2007. Noncardiogenic acute respiratory failure among black Americans increased from 56.4 (95% confidence interval 39.7-73.1) to 143.8 (95% confidence interval 123.8-163.8) cases per 100,000 in 1992 and 2007, respectively. Among white Americans, the incidence of noncardiogenic acute respiratory failure increased from 31.2 (95% confidence interval 26.2-36.5) to 94.0 (95% confidence interval 86.7-101.2) cases per 100,000 in 1992 and 2007, respectively. The average annual incidence of noncardiogenic acute respiratory failure over the entire study period was 95.1 (95% confidence interval 93.9-96.4) cases per 100,000 for black Americans compared to 66.5 (95% confidence interval 65.8-67.2) cases per 100,000 for white Americans (rate ratio 1.43, 95% confidence interval 1.42-1.44). Overall in-hospital mortality was greater for other-race Americans, but only among patients with two or more organ failures (57% [95% confidence interval 56%-59%] for other race, 51% [95% confidence interval 50%-52%] for white, 50% [95% confidence interval 49%-51%] for black).
  
  
  CONCLUSIONS
  The incidence of noncardiogenic acute respiratory failure in the United States increased between 1992 and 2007. Black and other-race Americans are at greater risk of developing noncardiogenic acute respiratory failure compared to white Americans.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Robert Wood Johnson Foundation Clinical Scholars Program, Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, MI, USA. cookecr@umich.edu
authors.forename: Colin R
authors.initials: CR
authors.lastname: Cooke
authors.forename: Sara E
authors.initials: SE
authors.lastname: Erickson
authors.forename: Mark D
authors.initials: MD
authors.lastname: Eisner
authors.forename: Greg S
authors.initials: GS
authors.lastname: Martin
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D044383:Black People / Q000706:statistics & numerical data; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D044469:Racial Groups / Q000706:statistics & numerical data*; D012131:Respiratory Insufficiency / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American