title: Markers of poor outcome in patients with acute hypoxemic respiratory failure.
abstract: OBJECTIVE
  This study described the acute hypoxemic respiratory failure (AHRF) population and identified potential modifiable markers of outcome.
  
  
  METHODS
  A prospective, multicenter study was performed in 22 intensive care units (ICUs). The clinical outcomes of patients with acute respiratory distress syndrome (ARDS) were compared to the outcomes in patients with non-ARDS AHRF, and a propensity score matched analysis was performed.
  
  
  RESULTS
  A total 837 patients with an arterial oxygen tension/fraction of inspired oxygen ratio (Pao2/Fio2) less than 300 mm Hg on ICU admission were included. Of these, 163 patients met the criteria defining ARDS, whereas the remaining 674 patients who had unilateral or no pulmonary opacities were classified as non-ARDS AHRF. Baseline Pao2/Fio2 ratio, thrombocytopenia, increased positive end-expiratory pressure (PEEP) were significantly associated with the 60-day mortality in hypoxemic respiratory failure after multivariate analysis. However, ARDS was not associated with increased 60-day mortality when independent predictors for the 60-day mortality and propensity score were controlled. In the case-control study, the 60-day mortality rate was 38.6% in the ARDS group and 32.3% in the non-ARDS AHRF group. In both patients with ARDS and non-ARDS AHRF, the mortality rate increased proportionally to a lower baseline Pao2/Fio2.
  
  
  CONCLUSIONS
  Lower baseline oxygenation (Pao2/Fio2) is a poor prognostic marker in acute hypoxemic respiratory failure.
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea.
authors.forename: Won-Il
authors.initials: WI
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Keimyung University School of Medicine, Daegu, South Korea; Department of Internal Medicine, Regional Hospital of Durres, Albania.
authors.forename: Esmeralda
authors.initials: E
authors.lastname: Shehu
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: So Yeon
authors.initials: SY
authors.lastname: Lim
authors.affiliation: Department of Anesthesiology and Pain Medicine, and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Shin Ok
authors.initials: SO
authors.lastname: Koh
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.affiliation: Department of Anesthesiology and Pain Medicine, and Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sungwon
authors.initials: S
authors.lastname: Na
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Chae-Man
authors.initials: CM
authors.lastname: Lim
authors.affiliation: Department of Anesthesiology, Aju University College of Medicine, Suwon, Republic of Korea.
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Seok Chan
authors.initials: SC
authors.lastname: Kim
authors.affiliation: Department of Surgery, Chungju hospital, School of Medicine, Konkuk University, Chungju, Republic of Korea.
authors.forename: Ick Hee
authors.initials: IH
authors.lastname: Kim
authors.affiliation: Division of Pulmonary, Sleep and Critical Care Medicine, Department of Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.
authors.forename: Je Hyeong
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Yeol
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Gangneung Asan Hospital, Gangneung, University of Ulsan Medical College of Medicine, Gangneung, Republic of Korea.
authors.forename: Jaemin
authors.initials: J
authors.lastname: Lim
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Seoul St. Mary's Hospital, Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Chin Kook
authors.initials: CK
authors.lastname: Rhee
authors.affiliation: Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea.
authors.forename: Sunghoon
authors.initials: S
authors.lastname: Park
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, College of Medicine, Gyeongsang Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea.
authors.forename: Ho Cheol
authors.initials: HC
authors.lastname: Kim
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
authors.forename: Jin Hwa
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Bundang CHA hospital CHA university, Seongnam, Republic of Korea.
authors.forename: Ji Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Multimedia, Seoul Women's University, Seoul, Republic of Korea.
authors.forename: Jisook
authors.initials: J
authors.lastname: Park
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Younsuck
authors.initials: Y
authors.lastname: Koh
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: suhgy@skku.edu.
authors.forename: Gee Young
authors.initials: GY
authors.lastname: Suh
mesh_terms: D000368:Aged; D001784:Blood Gas Analysis; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000401:mortality* / Q000503:physiopathology; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010100:Oxygen; D010313:Partial Pressure; D011175:Positive-Pressure Respiration; D057216:Propensity Score; D011446:Prospective Studies; D012128:Respiratory Distress Syndrome / Q000401:mortality* / Q000503:physiopathology; D012131:Respiratory Insufficiency / Q000401:mortality* / Q000503:physiopathology; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D010100:Oxygen
keywords: ARDS; Acute respiratory failure; Hypoxemia