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. 2020 Feb;48(2):300060519895659.
doi: 10.1177/0300060519895659.

Prevalence, potential risk factors and mortality rates of acute respiratory distress syndrome in Chinese patients with sepsis

Shilei Li  1 , Danna Zhao  2 , Jie Cui  1 , Lizeng Wang  1 , Xiaohua Ma  1 , Yong Li  1
Affiliations

Prevalence, potential risk factors and mortality rates of acute respiratory distress syndrome in Chinese patients with sepsis

Shilei Li et al. J Int Med Res. 2020 Feb.

Abstract

Objective: To investigate the prevalence, risk factors and mortality rate for acute respiratory distress syndrome (ARDS) in Chinese patients with sepsis.

Methods: This prospective study was based on data from consecutive patients with sepsis who attended Cangzhou Central Hospital between January 2017 and May 2019 and who developed ARDS. Multivariate logistic regression was used to identify risk factors associated independently with ARDS development.

Results: Of the 150 sepsis patients, 41 (27%) developed ARDS. Smoking history, presence of chronic obstructive pulmonary disease (COPD), the C-reactive protein (CRP) levels and the Acute Physiology and Chronic Health Evaluation II (APACHE II) scores were associated with developing ARDS. Moreover, combination of the four factors had an even better predictive value for risk of ARDS than each factor alone. 28-day mortality was higher in sepsis patients with ARDS compared with those without ARDS.

Conclusions: In Chinese patients with sepsis, ARDS is relatively common and is associated with increased mortality. Smoking, COPD, CRP levels and APACHE II scores may be useful in predicting sepsis patients who may be at risk of developing ARDS.

Keywords: Sepsis; acute respiratory distress syndrome; risk factors.

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Figures

Figure 1.
Figure 1.
The percentage of sepsis patients with and without acute respiratory distress syndrome (ARDS) (n=150).
Figure 2.
Figure 2.
Receiver operating characteristic (ROC) curve analysis. The analysis showed that smoking status (area under the curve [AUC]: 0.60, 95%CI: 0.50, 0.71), presence of chronic obstructive pulmonary disease (COPD) (AUC: 0.60, 95%CI: 0.49, 0.70), C-reactive protein (CRP) levels (AUC: 0.68, 95%CI: 0.57, 0.79) and Acute Physiology and Chronic Health Evaluation (APACHE) II scores (AUC: 0.69, 95%CI: 0.60, 0.79) could predict increased risk from acute respiratory distress syndrome (ARDS) in sepsis patients. The combination of the four risk factors had a greater predictive value than each individual factor (AUC: 0.80, 95%CI: 0.71, 0.89).
Figure 3.
Figure 3.
(a) The 28-day mortality rates in sepsis patients and (b) those with and without acute respiratory distress syndrome (ARDS).
See this image and copyright information in PMC

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