title: Epidemiological profile of acute respiratory distress syndrome patients: A tertiary care experience.
abstract: BACKGROUND
  Acute respiratory distress syndrome (ARDS) is seen in critically ill patients. Its etiological spectrum in India is expected to be different from that seen in western countries due to the high prevalence of tropical infections.
  
  
  OBJECTIVE
  To study the epidemiological profile of ARDS patients.
  
  
  METHODS
  A tertiary care hospital in Karnataka, India.
  
  
  METHODS
  Retrospective analysis of 150 out of the 169 ARDS patients diagnosed during 2010-2012. Data collected included the clinical features and severity scoring parameters.
  
  
  RESULTS
  The mean age of the study population was 42.92 ± 13.91 years. The causes of ARDS included pneumonia (n= 35, 23.3%), scrub typhus (n= 33, 22%), leptospirosis (n= 11, 7.3%), malaria (n= 6, 4%), influenza (H1N1) (n= 10, 6.7%), pulmonary tuberculosis (n= 2, 1.3%), dengue (n= 1, 0.7%), abdominal sepsis (n= 16, 10.7%), skin infection (n= 3, 2%), unknown cause of sepsis (n= 18, 12%), and nonseptic causes (n= 15, 10%). A total of 77 (51.3%) patients survived, 66 (44%) expired, and 7 (4.7%) were discharged against medical advice (AMA). Preexisting comorbidities (46) were present in 13 survivors, 19 nonsurvivors, and four discharged AMA. History of surgery prior to the onset of ARDS was present in one survivor, 13 nonsurvivors, and one discharge AMA. Mean Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE III, and Sequential Organ Failure Assessment scores in survivors were 9.06 ± 4.3, 49.22 ± 14, and 6.43 ± 2.5 and in nonsurvivors 21.11 ± 7, 86.45 ± 23.5, and 10.6 ± 10, respectively.
  
  
  CONCLUSIONS
  The most common cause of ARDS in our study was pneumonia, but a large percentage of cases were due to the tropical infections. Preexisting comorbidity, surgery prior to the onset of ARDS, higher severity scores, and organ failure scores were more frequently observed among nonsurvivors than survivors.
authors.affiliation: Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Magazine
authors.affiliation: Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Shobitha
authors.initials: S
authors.lastname: Rao
authors.affiliation: Department of Pharmacology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Bharti
authors.initials: B
authors.lastname: Chogtu
authors.affiliation: Department of Anaesthesiology, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Ramkumar
authors.initials: R
authors.lastname: Venkateswaran
authors.affiliation: Department of Pulmonary Medicine, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.
authors.forename: Hameed Aboobackar
authors.initials: HA
authors.lastname: Shahul
authors.affiliation: Department of Anaesthesiology, Dharwad Institute of Mental Health and Neurosciences, Dharwad, Karnataka, India.
authors.forename: Umesh
authors.initials: U
authors.lastname: Goneppanavar
keywords: Acute respiratory distress syndrome; pneumonia; tropical infectious diseases