Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2011 Jan 1;183(1):59-66.
doi: 10.1164/rccm.201003-0436OC. Epub 2010 Aug 6.

Eight-year trend of acute respiratory distress syndrome: a population-based study in Olmsted County, Minnesota

Guangxi Li  1 , Michael Malinchoc, Rodrigo Cartin-Ceba, Chakradhar V Venkata, Daryl J Kor, Steve G Peters, Rolf D Hubmayr, Ognjen Gajic
Affiliations
Comparative Study

Eight-year trend of acute respiratory distress syndrome: a population-based study in Olmsted County, Minnesota

Guangxi Li et al. Am J Respir Crit Care Med. .

Abstract

Rationale: significant progress has been made in understanding the pathogenesis of acute respiratory distress syndrome (ARDS). Recent advances in hospital practice may have reduced the incidence of this lethal syndrome.

Objectives: to observe incidence trends and associated outcomes of ARDS.

Methods: this population-based cohort study was conducted in Olmsted County, Minnesota. Using a validated screening protocol, investigators identified intensive care patients with acute hypoxemia and bilateral pulmonary infiltrates. The presence of ARDS was independently confirmed according to American-European Consensus Conference criteria. The incidence of ARDS and associated outcomes were compared over the 8-year study period (2001-2008).

Measurements and main results: over the 8-year period, critically ill Olmsted County residents presented with increasing severity of acute illness, a greater number of comorbidities, and a higher prevalence of major predisposing conditions for ARDS. The ARDS incidence decreased significantly from 82.4 to 38.9 per 100,000 person-years during the study period (P < 0.001). A decline in hospital-acquired ARDS (P < 0.001) was responsible for the fall in the incidence density with no change on admission (P = 0.877). Overall, mortality and hospital and intensive care unit lengths of stay decreased over time (P < 0.001), whereas the ARDS case-fatality did not change significantly.

Conclusions: despite an increase in patients' severity of illness, number of comorbidities, and prevalence of major ARDS risk factors, the incidence of ARDS in this suburban community decreased by more than half. Correlation of the observed findings with changes in health care delivery may have important implications for the planning of acute care services in other regions.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Outline of the acute respiratory distress syndrome screening protocol and case ascertainment. AECC = American-European Consensus Conference; ALI = acute lung injury; ARDS = acute respiratory distress syndrome; ICU = intensive care unit; PF = PaO2/FiO2.
Figure 2.
Figure 2.
Trends in age- and sex-specific incidence of acute respiratory distress syndrome from 2001–2008 in Olmsted County, Minnesota; dotted lines represent 95% confidence intervals. ALI = acute lung injury.
Figure 3.
Figure 3.
(A) Trends of community-acquired acute respiratory distress syndrome incidence from 2001–2008 in Olmsted County, Minnesota; dotted lines represent 95% confidence intervals. (B) Trends of hospital-acquired acute respiratory distress syndrome incidence from 2001–2008 in Olmsted County, Minnesota; dotted lines represent 95% confidence intervals. ALI = acute lung injury.
Figure 4.
Figure 4.
Changes in hospital care delivery. 1CPOE = computerized provider order entry; 2P for linear trends less than 0.0001; 3Average tidal volume at the onset of mechanical ventilation (milliliter per kilogram predicted body weight); 4MICU = medical intensive care unit.
See this image and copyright information in PMC

Comment in

  • Better supportive care, less ARDS: just do it?
    Bersten AD, Cooper DJ. Bersten AD, et al. Am J Respir Crit Care Med. 2011 Jan 1;183(1):6-7. doi: 10.1164/rccm.201007-1139ED. Am J Respir Crit Care Med. 2011. PMID: 21193784 No abstract available.

References

    1. Rubenfeld GD, Caldwell E, Peabody E, Weaver J, Martin DP, Neff M, Stern EJ, Hudson LD. Incidence and outcomes of acute lung injury. N Engl J Med 2005;353:1685–1693. - PubMed
    1. Ashbaugh DG, Bigelow DB, Petty TL, Levine BE. Acute respiratory distress in adults. Lancet 1967;2:319–323. - PubMed
    1. Luhr OR, Antonsen K, Karlsson M, Aardal S, Thorsteinsson A, Frostell CG, Bonde J. Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland. Am J Respir Crit Care Med 1999;159:1849–1861. - PubMed
    1. Bersten AD, Edibam C, Hunt T, Moran J. Incidence and mortality of acute lung injury and the acute respiratory distress syndrome in three Australian states. Am J Respir Crit Care Med 2002;165:443–448. - PubMed
    1. Linde-Zwirble WT, Angus DC. Severe sepsis epidemiology: sampling, selection, and society. Crit Care 2004;8:222–226. - PMC - PubMed

Publication types