The Impact of Chronic Medical Conditions on Mortality in Acute Respiratory Distress Syndrome.

Publication/Presentation Date

1-1-2023

Abstract

PURPOSE: To examine the impact of chronic comorbidities on mortality in Acute Respiratory Distress Syndrome (ARDS).

MATERIALS AND METHODS: Retrospective cohort study of adults with ARDS (ICD-10-CM code J80) from the National Inpatient Sample between January, 2016 and December, 2018. For the primary outcome of mortality, we conducted weighted logistic regression adjusting for factors identified on univariate analysis as potentially significant or differing between the two groups at baseline. We used negative binomial regression adjusting for the same comorbidities to identify risk factors for longer length of stay (LOS) among ARDS survivors.

RESULTS: After exclusions, 1046 records were analyzed (3355 ARDS survivors and 1875 non-survivors.) The comorbidities examined included hypertension, diabetes mellitus, obesity, hypothyroidism, alcohol and drug use, chronic kidney disease (CKD), cardiovascular disease, chronic liver disease, chronic pulmonary disease and malignancy. In multivariate analysis, we found that malignancy (OR 2.26, 95% CI 1.84-2.78, p <  0.001), cardiovascular disease (OR 1.54, 95% CI 1.23-1.92, p <  0.001), and CKD (OR 1.75, 95% CI 1.22-2.50, p  =  0.002) increased the risk of death. In interaction analyses, cardiovascular disease combined with either malignancy or CKD conferred higher odds of death compared to either risk factor alone.

CONCLUSIONS: The comorbidity of malignancy confers the most reliable risk of poor outcomes in ARDS with higher odds of hospital death and a simultaneous association with longer hospital LOS among survivors.

Volume

38

Issue

1

First Page

78

Last Page

85

ISSN

1525-1489

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

35722731

Department(s)

Administration and Leadership

Document Type

Article

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