National incidence rates for Acute Respiratory Distress Syndrome (ARDS) and ARDS cause-specific factors in the United States (2006-2014)

Efe Eworuke; Jacqueline M Major; Lydia I Gilbert McClain

doi:10.1016/j.jcrc.2018.07.002

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.

Authors

Efe Eworuke¹, Jacqueline M Major², Lydia I Gilbert McClain³

Affiliations

¹ Division of Epidemiology II, Office of Pharmacovigilance and Epidemiology, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, United States of America. Electronic address: efe.eworuke@fda.hhs.gov.
² Division of Epidemiology II, Office of Pharmacovigilance and Epidemiology, Office of Surveillance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, United States of America.
³ Division of Pulmonary, Allergy, and Rheumatology Products, Office of New Drugs, Center for Drug Evaluation and Research, Food and Drug Administration, United States of America.

PMID: 30015289
DOI: 10.1016/j.jcrc.2018.07.002

Abstract

Purpose: To estimate the incidence of Acute Respiratory Distress Syndrome (ARDS) and ARDS-related mortality rates.

Methods: We identified patients with a risk factor for ARDS in the National Inpatient Sample (NIS) (2006-2014). Using survey-weighted descriptive statistics we estimated annual and overall proportions of ARDS cases.

Results: From over 69 million discharges, 1,151,969 ARDS discharges and 969,567 ARDS discharges with a risk factor were identified. Sepsis (46.8%), pneumonia (44.9%) and shock (44.4%) were the most common ARDS risk factor. Pancreatitis (3.4%), pulmonary contusion (1.4%) and drowning (0.2%) were the least frequently reported. Incidence rates increased from 180.7 (2006) to 220.8 (2011) and again from 182.8 (2012) to 193.4 (2014). Incidence for pneumonia, shock and sepsis-associated ARDS increased steadily, while transfusion and trauma-associated ARDS declined. Trends for gastric aspiration and pancreatitis-related ARDS remained unchanged. Shock, sepsis and transfusion-associated ARDS had higher mortality rates compared to other factors. Except for transfusion and trauma-associated ARDS, mortality rates for other factors declined.

Conclusion: Although increasing incidence for ARDS was observed, mortality rates declined for most risk factors. Mortality for transfusion and trauma-associated ARDS increased in the later study period, research is needed to examine reasons for the increasing in-hospital deaths associated with these risk factors.

Keywords: Acute lung injury; Acute respiratory distress syndrome; Epidemiology; Incidence; Risk factors.

Published by Elsevier Inc.

MeSH terms

Adolescent
Adult
Age Distribution
Aged
Child
Comorbidity
Female
Humans
Incidence
Male
Middle Aged
Prospective Studies
Respiratory Distress Syndrome / epidemiology*
Risk Factors
United States / epidemiology