George Kasotakis1, Brent Stanfield2, Krista Haines3, Cory Vatsaas4, Amy Alger5, Steven N Vaslef6, Kelli Brooks7, Suresh Agarwal8. 1. Department of Surgery, Duke University School of Medicine, United States of America. Electronic address: george.kasotakis@duke.edu. 2. Department of Surgery, Duke University School of Medicine, United States of America. Electronic address: brent.stanfield@duke.edu. 3. Department of Surgery, Duke University School of Medicine, United States of America. Electronic address: krista.haines@duke.edu. 4. Department of Surgery, Duke University School of Medicine, United States of America. Electronic address: cory.vatsaas@duke.edu. 5. Department of Surgery, Duke University School of Medicine, United States of America. Electronic address: amy.alger@duke.edu. 6. Department of Surgery, Duke University School of Medicine, United States of America. Electronic address: steven.vaslef@duke.edu. 7. Department of Surgery, Duke University School of Medicine, United States of America. Electronic address: kelli.brooks@duke.edu. 8. Department of Surgery, Duke University School of Medicine, United States of America. Electronic address: suresh.agarwal@duke.edu.
Abstract
PURPOSE: Acute Respiratory Distress Syndrome (ARDS) is an infrequent, yet morbid inflammatory complication in injury victims. With the current project we sought to estimate trends in incidence, determine outcomes, and identify risk factors for ARDS and related mortality. MATERIALS & METHODS: The national Trauma Quality Improvement Program dataset (2010-2014) was queried. Demographics, injury characteristics and outcomes were compared between patients who developed ARDS and those who did not. Logistic regression models were fitted for the development of ARDS and mortality respectively, adjusting for relevant confounders. RESULTS: In the studied 808,195 TQIP patients, incidence of ARDS decreased over the study years (3-1.1%, p < 0.001), but related mortality increased (18.-21%, p = 0.001). ARDS patients spent an additional 14.7 ± 10.3 days in the hospital, 9.7 ± 7.9 in the ICU, and 6.6 ± 9.4 on mechanical ventilation (all p < 0.001). Older age, male gender, African American race increased risk for ARDS. Age, male gender, lower GCS and higher ISS also increased mortality risk among ARDS patients. Several pre-existing comorbidities including chronic alcohol use, diabetes, smoking, and respiratory disease also increased risk. CONCLUSION: Although the incidence of ARDS after trauma appears to be declining, mortality is on the rise.
PURPOSE:Acute Respiratory Distress Syndrome (ARDS) is an infrequent, yet morbid inflammatory complication in injury victims. With the current project we sought to estimate trends in incidence, determine outcomes, and identify risk factors for ARDS and related mortality. MATERIALS & METHODS: The national Trauma Quality Improvement Program dataset (2010-2014) was queried. Demographics, injury characteristics and outcomes were compared between patients who developed ARDS and those who did not. Logistic regression models were fitted for the development of ARDS and mortality respectively, adjusting for relevant confounders. RESULTS: In the studied 808,195 TQIP patients, incidence of ARDS decreased over the study years (3-1.1%, p < 0.001), but related mortality increased (18.-21%, p = 0.001). ARDSpatients spent an additional 14.7 ± 10.3 days in the hospital, 9.7 ± 7.9 in the ICU, and 6.6 ± 9.4 on mechanical ventilation (all p < 0.001). Older age, male gender, African American race increased risk for ARDS. Age, male gender, lower GCS and higher ISS also increased mortality risk among ARDSpatients. Several pre-existing comorbidities including chronic alcohol use, diabetes, smoking, and respiratory disease also increased risk. CONCLUSION: Although the incidence of ARDS after trauma appears to be declining, mortality is on the rise.
Authors: Lilian Jo Engelhardt; Claudio Olbricht; Marcel Niemann; Jan Adriaan Graw; Oliver Hunsicker; Björn Weiss; Victoria Bünger; Steffen Weber-Carstens; Sebastian Daniel Boie; Sophie K Piper; Felix Balzer; Mario Menk Journal: J Clin Med Date: 2022-09-28 Impact factor: 4.964