Covid-19 Research

Patient Demographics Associated with ARDS Incidence, Hospital Length of Stay and Mortality

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Abstract

Introduction: Acute Respiratory Distress Syndrome (ARDS) is a common finding among pediatric and adult patient populations [1]. ARDS-related mortality remains high and is associated with prolonged hospital Length of Stay (LOS) and multiple ventilator days. Studies have sought to predict whether certain risk factors can be associated with ARDS development and mortality. It remains to be established whether a strong association exists between ARDS patient demographic characteristics, hospital LOS and overall ARDS-related mortali [4].

Methods: A retrospective analysis of Electronic Health Record (EHR) data identified 595 adult subjects that received an ARDS diagnosis: ICD-9: 518.82, ICD-10: J96.00 or J80 annotation. The analysis spanned a 30-month period, evaluating subjects by age, gender, race, BMI, LOS, and mortality.

Results: The majority of subjects were admitted through the Emergency Department (408: 68.6%) and were followed by Internal Medicine (137: 23%) or Trauma service (117: 19.7%). A significant portion of subjects expired (130: 21.8%), but a majority were discharged to home care (212: 35.6%). A binomial logistic regression was performed to identify whether a prevalence or risk ratio could be identified between subject demographics and either LOS or mortality. LOS in days was associated with an increased likelihood of mortality (1.055), and age at admission was associated with a reduction in the likelihood of mortality (0.986).

Conclusions: No statistically significant predictor of mortality was identified among subject demographic variables. The findings did suggest that mortality in subjects was higher with longer hospital LOS, lower overall in younger subjects, and inversely related to BMI.

Tim W Gilmore* and Clifton F Frilot
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Volume1-Issue5 | Published: 2020-09-18

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References


  1. Ware LB, Matthay MA. The acute respiratory distress syndrome. N Engl J Med. 2000; 342: 1334-1349. DOI: 10.1056/NEJM200005043421806. https://bit.ly/32zJCOl
  2. Gattinoni L, Pelosi P, Suter PM, Pedoto A, Vercesi P, Lissoni A. Acute respiratory distress syndrome caused by pulmonary and extrapulmonary disease. Different syndromes? Am J Respir Crit Care Med. 1998 Jul;158(1):3-11. doi: 10.1164/ajrccm.158.1.9708031. PMID: 9655699.
  3. Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, Gattinoni L, van Haren F, Larsson A, McAuley DF, Ranieri M, Rubenfeld G, Thompson BT, Wrigge H, Slutsky AS, Pesenti A; LUNG SAFE Investigators; ESICM Trials Group. Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries. JAMA. 2016 Feb 23;315(8):788-800. doi: 10.1001/jama.2016.0291. Erratum in: JAMA. 2016 Jul 19;316(3):350. Erratum in: JAMA. 2016 Jul 19;316(3):350. PMID: 26903337.
  4. Herridge MS, Tansey CM, Matté A, Tomlinson G, Diaz-Granados N, Cooper A, Guest CB, Mazer CD, Mehta S, Stewart TE, Kudlow P, Cook D, Slutsky AS, Cheung AM; Canadian Critical Care Trials Group. Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med. 2011 Apr 7;364(14):1293-304. doi: 10.1056/NEJMoa1011802. PMID: 21470008.
  5. Máca J, Jor O, Holub M, Sklienka P, Burša F, Burda M, Janout V, Ševčík P. Past and Present ARDS Mortality Rates: A Systematic Review. Respir Care. 2017 Jan;62(1):113-122. doi: 10.4187/respcare.04716. Epub 2016 Nov 1. PMID: 27803355.
  6. Pham T, Rubenfeld GD. Fifty Years of Research in ARDS. The Epidemiology of Acute Respiratory Distress Syndrome. A 50th Birthday Review. Am J Respir Crit Care Med. 2017 Apr 1;195(7):860-870. doi: 10.1164/rccm.201609-1773CP. PMID: 28157386.
  7. Shankar-Hari M, McAuley DF. Acute Respiratory Distress Syndrome Phenotypes and Identifying Treatable Traits. The Dawn of Personalized Medicine for ARDS. Am J Respir Crit Care Med. 2017 Feb 1;195(3):280-281. doi: 10.1164/rccm.201608-1729ED. PMID: 28145757.
  8. McNicholas BA, Rooney GM, Laffey JG. Lessons to learn from epidemiologic studies in ARDS. Curr Opin Crit Care. 2018 Feb;24(1):41-48. doi: 10.1097/MCC.0000000000000473. PMID: 29135617.
  9. Eworuke E, Major JM, Gilbert McClain LI. National incidence rates for Acute Respiratory Distress Syndrome (ARDS) and ARDS cause-specific factors in the United States (2006-2014). J Crit Care. 2018 Oct;47:192-197. doi: 10.1016/j.jcrc.2018.07.002. Epub 2018 Jul 10. PMID: 30015289.
  10. Rubenfeld GD, Caldwell E, Peabody E, Weaver J, Martin DP, Neff M, Stern EJ, Hudson LD. Incidence and outcomes of acute lung injury. N Engl J Med. 2005 Oct 20;353(16):1685-93. doi: 10.1056/NEJMoa050333. PMID: 16236739.
  11. McNicholas BA, Madotto F, Pham T, Rezoagli E, Masterson CH, Horie S, Bellani G, Brochard L, Laffey JG; LUNG SAFE Investigators and the ESICM Trials Group. Demographics, management and outcome of females and males with acute respiratory distress syndrome in the LUNG SAFE prospective cohort study. Eur Respir J. 2019 Oct 17;54(4):1900609. doi: 10.1183/13993003.00609-2019. PMID: 31346004.
  12. Gong MN, Bajwa EK, Thompson BT, Christiani DC. Body mass index is associated with the development of acute respiratory distress syndrome. Thorax. 2010 Jan;65(1):44-50. doi: 10.1136/thx.2009.117572. Epub 2009 Sep 21. PMID: 19770169; PMCID: PMC3090260.
  13. Ni YN, Luo J, Yu H, Wang YW, Hu YH, Liu D, Liang BM, Liang ZA. Can body mass index predict clinical outcomes for patients with acute lung injury/acute respiratory distress syndrome? A meta-analysis. Crit Care. 2017 Feb 22;21(1):36. doi: 10.1186/s13054-017-1615-3. PMID: 28222804; PMCID: PMC5320793.
  14. Sattar N, Ho FK, Gill JM, Ghouri N, Gray SR, Celis-Morales CA, Katikireddi SV, Berry C, Pell JP, McMurray JJ, Welsh P. BMI and future risk for COVID-19 infection and death across sex, age and ethnicity: Preliminary findings from UK biobank. Diabetes Metab Syndr. 2020 Sep-Oct;14(5):1149-1151. doi: 10.1016/j.dsx.2020.06.060. Epub 2020 Jun 30. PMID: 32668401; PMCID: PMC7326434.
  15. Caci G, Albini A, Malerba M, Noonan DM, Pochetti P, Polosa R. COVID-19 and Obesity: Dangerous Liaisons. J Clin Med. 2020 Aug 4;9(8):2511. doi: 10.3390/jcm9082511. PMID: 32759719; PMCID: PMC7465218.
  16. Lighter J, Phillips M, Hochman S, Sterling S, Johnson D, Francois F, Stachel A. Obesity in Patients Younger Than 60 Years Is a Risk Factor for COVID-19 Hospital Admission. Clin Infect Dis. 2020 Jul 28;71(15):896-897. doi: 10.1093/cid/ciaa415. PMID: 32271368; PMCID: PMC7184372.
  17. Ruhl AP, Huang M, Colantuoni E, Karmarkar T, Dinglas VD, Hopkins RO, Needham DM; With the National Institutes of Health, National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network. Healthcare utilization and costs in ARDS survivors: a 1-year longitudinal national US multicenter study. Intensive Care Med. 2017 Jul;43(7):980-991. doi: 10.1007/s00134-017-4827-8. Epub 2017 May 26. PMID: 28550403.
  18. El-Haddad H, Jang H, Chen W, Haider S, Soubani AO. The effect of demographics and patient location on the outcome of patients with acute respiratory distress syndrome. Ann Thorac Med. 2017 Jan-Mar;12(1):17-24. doi: 10.4103/1817-1737.197767. PMID: 28197217; PMCID: PMC5264167.
  19. Sakr Y, Alhussami I, Nanchal R, Wunderink RG, Pellis T, Wittebole X, Martin-Loeches I, François B, Leone M, Vincent JL; Intensive Care Over Nations Investigators. Being Overweight Is Associated With Greater Survival in ICU Patients: Results From the Intensive Care Over Nations Audit. Crit Care Med. 2015 Dec;43(12):2623-32. doi: 10.1097/CCM.0000000000001310. PMID: 26427591.
  20. Zhi G, Xin W, Ying W, Guohong X, Shuying L. “Obesity Paradox” in Acute Respiratory Distress Syndrome: Asystematic Review and Meta-Analysis. PLoS One. 2016 Sep 29;11(9):e0163677. doi: 10.1371/journal.pone.0163677. PMID: 27684705; PMCID: PMC5042414.
  21. Yang J, Hu J, Zhu C. Obesity aggravates COVID-19: a systematic review and meta-analysis. J Med Virol. 2020 Jun 30:10.1002/jmv.26237. doi: 10.1002/jmv.26237. Epub ahead of print. PMID: 32603481; PMCID: PMC7361606.
  22. Popkin BM, Du S, Green WD, Beck MA, Algaith T, Herbst CH, Alsukait RF, Alluhidan M, Alazemi N, Shekar M. Individuals with obesity and COVID-19: A global perspective on the epidemiology and biological relationships. Obes Rev. 2020 Aug 26:10.1111/obr.13128. doi: 10.1111/obr.13128. Epub ahead of print. PMID: 32845580; PMCID: PMC7461480.
  23. Grieco DL, Bongiovanni F, Chen L, Menga LS, Cutuli SL, Pintaudi G, Carelli S, Michi T, Torrini F, Lombardi G, Anzellotti GM, De Pascale G, Urbani A, Bocci MG, Tanzarella ES, Bello G, Dell’Anna AM, Maggiore SM, Brochard L, Antonelli M. Respiratory physiology of COVID-19-induced respiratory failure compared to ARDS of other etiologies. Crit Care. 2020 Aug 28;24(1):529. doi: 10.1186/s13054-020-03253-2. PMID: 32859264; PMCID: PMC7453378.


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