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Acute Respiratory Distress Syndrome Incidence, But Not Mortality, Has Decreased Nationwide: A National Trauma Data Bank Study.

Abstract Acute respiratory distress syndrome (ARDS) incidence is reported to have decreased in recent years. However, no large-scale study to date has exclusively examined ARDS in the critically injured. We sought to examine the national incidence of ARDS and its associated outcomes exclusively in adult trauma patients. The National Trauma Data Bank (NTDB) was queried to evaluate the incidence of ARDS and associated outcomes over a 6-year study period (2007-2012). Included patients were ≥18 years old, with at least one ventilator day, and complications recorded. ARDS-associated outcomes and complications were also analyzed. Mean age increased over the study period (48.1-51.4 years, P < 0.003). ARDS incidence decreased from 21.5 to 8.5 per cent (P < 0.001). Length of stay (LOS), intensive care unit LOS (ICU LOS), and ventilator days decreased over time. Mortality increased from 21.3 to 24.9 per cent (P < 0.002). Incidence of pneumonia and acute kidney injury increased marginally (39.5-40.9% and 11.4-12.3%, respectively). Sepsis trended down from 2007 to 2010, after which comparable NTDB data were not available. ARDS incidence in mechanically ventilated adult trauma patients has decreased significantly in recent years. We theorize this is likely attributable to improved critical care strategies. Unlike ARDS incidence, mortality in this patient population has not improved despite these advancements.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the american surgeon
Publication Year Start




PMID- 28424124
OWN - NLM
STAT- MEDLINE
DA  - 20170420
DCOM- 20170501
LR  - 20170501
IS  - 1555-9823 (Electronic)
IS  - 0003-1348 (Linking)
VI  - 83
IP  - 4
DP  - 2017 Apr 01
TI  - Acute Respiratory Distress Syndrome Incidence, But Not Mortality, Has Decreased
      Nationwide: A National Trauma Data Bank Study.
PG  - 323-331
AB  - Acute respiratory distress syndrome (ARDS) incidence is reported to have
      decreased in recent years. However, no large-scale study to date has exclusively 
      examined ARDS in the critically injured. We sought to examine the national
      incidence of ARDS and its associated outcomes exclusively in adult trauma
      patients. The National Trauma Data Bank (NTDB) was queried to evaluate the
      incidence of ARDS and associated outcomes over a 6-year study period (2007-2012).
      Included patients were &gt;/=18 years old, with at least one ventilator day, and
      complications recorded. ARDS-associated outcomes and complications were also
      analyzed. Mean age increased over the study period (48.1-51.4 years, P &lt; 0.003). 
      ARDS incidence decreased from 21.5 to 8.5 per cent (P &lt; 0.001). Length of stay
      (LOS), intensive care unit LOS (ICU LOS), and ventilator days decreased over
      time. Mortality increased from 21.3 to 24.9 per cent (P &lt; 0.002). Incidence of
      pneumonia and acute kidney injury increased marginally (39.5-40.9% and
      11.4-12.3%, respectively). Sepsis trended down from 2007 to 2010, after which
      comparable NTDB data were not available. ARDS incidence in mechanically
      ventilated adult trauma patients has decreased significantly in recent years. We 
      theorize this is likely attributable to improved critical care strategies. Unlike
      ARDS incidence, mortality in this patient population has not improved despite
      these advancements.
FAU - Fahr, Michael
AU  - Fahr M
FAU - Jones, Glenn
AU  - Jones G
FAU - O'Neal, Hollis
AU  - O'Neal H
FAU - Duchesne, Juan
AU  - Duchesne J
FAU - Tatum, Danielle
AU  - Tatum D
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
SB  - IM
MH  - Adult
MH  - Aged
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Intensive Care Units/utilization
MH  - Kidney Diseases/epidemiology
MH  - Length of Stay/statistics &amp; numerical data
MH  - Male
MH  - Middle Aged
MH  - Pneumonia/epidemiology
MH  - Respiration, Artificial/statistics &amp; numerical data
MH  - Respiratory Distress Syndrome, Adult/*epidemiology/mortality
MH  - Risk Factors
MH  - Sepsis/epidemiology
MH  - Survival Analysis
MH  - Trauma Centers
MH  - United States/epidemiology
MH  - Wounds and Injuries/*epidemiology
EDAT- 2017/04/21 06:00
MHDA- 2017/05/02 06:00
CRDT- 2017/04/21 06:00
PST - ppublish
SO  - Am Surg. 2017 Apr 1;83(4):323-331.

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