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ORIGINAL ARTICLE
Year : 2019  |  Volume : 14  |  Issue : 3  |  Page : 210-214

Clinical profile and survival outcome of acute respiratory distress syndrome in a rural tertiary care hospital


1 Department of Medicine, Datta Meghe Institute of Medical Sciences (Deemed to be University), Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
2 Department of Pathology, Datta Meghe Institute of Medical Sciences (Deemed to be University), Jawaharlal Nehru Medical College, Wardha, Maharashtra, India

Correspondence Address:
Dr. Sourya Acharya
Department of Medicine, Datta Meghe Institute of Medical Sciences (Deemed to be University), Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_116_19

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Background: Acute respiratory distress syndrome (ARDS) is characterized by rapid onset severe dyspnea, hypoxemia, and diffuse bilateral pulmonary infiltrates leading to respiratory failure. This syndrome can occur even without primary damage to the lung parenchyma, and thus, they are more often classified as ARDS due to pulmonary and extrapulmonary causes. Mortality estimates range from 26% to 44% in different studies. There are several critical care scores that are in vogue in intensive care units. This study was undertaken to describe the clinical profile of ARDS and along with that the study also intended to correlate the outcome of ARDS patients with reference to these critical care scores and try to establish which score would be best to prognosticate ARDS. Aims: This study aims to study the clinical profile and survival outcome of ARDS in a rural tertiary care hospital. Materials and Methods: All patients fulfilling the inclusion criteria as per the 1994 American European Consensus Conference on ARDS definition of ARDS were included in the study. The severity of ARDS was measured by various critical care scores such as the Acute Physiology and Chronic Health Evaluation Score, Multiple Organ Dysfunction Score (MODS), Lung Injury Score (LIS), and Sequential Organ Dysfunction Assessment (SOFA score). Results: The ratio of male and female (male: female) was 1.7:1.0. Proportion of males (62.5%) was significantly higher than that of females (37.5%) (Z = 3.53;P < 0.001). Clinical disorders pneumonia (35%), sepsis with multiorgan failure (27.5%), and tropical infections (21.5%) were significantly higher than that of other etiologies (Z = 3.68;P < 0.0001). The mean age, APACHE-II score, SOFA score, LIS, and MODS were significantly higher of the patients who died during treatment as compared to the patients who were discharged alive (P < 0.0001). In receiver operating characteristics/area under curve (AUC) analysis, AUC of MODS followed by SOFA score was higher than that of other scores. Thus, MODS Score was as good as SOFA score to predict death. Conclusion: In this study, the primary pulmonary infection/pneumonia, septicemia, and tropical infections were the leading causes of ARDS. Among the various scores; MODS and SOFA score predicted the mortality more accurately.


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