Risk modifiers of acute respiratory distress syndrome in patients with non-pulmonary sepsis: a retrospective analysis of the FORECAST study.
Acute respiratory distress syndrome
acute respiratory failure
sepsis
Journal
Journal of intensive care
ISSN: 2052-0492
Titre abrégé: J Intensive Care
Pays: England
ID NLM: 101627304
Informations de publication
Date de publication:
2020
2020
Historique:
received:
27
09
2019
accepted:
01
01
2020
entrez:
16
1
2020
pubmed:
16
1
2020
medline:
16
1
2020
Statut:
epublish
Résumé
Predisposing conditions and risk modifiers instead of causes and risk factors have recently been used as alternatives to identify patients at a risk of acute respiratory distress syndrome (ARDS). However, data regarding risk modifiers among patients with non-pulmonary sepsis is rare. We conducted a secondary analysis of the multicenter, prospective, Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis and Trauma (FORECAST) cohort study that was conducted in 59 intensive care units (ICUs) in Japan during January 2016-March 2017. Adult patients with severe sepsis caused by non-pulmonary infection were included, and the primary outcome was having ARDS, defined as meeting the Berlin definition on the first or fourth day of screening. Multivariate logistic regression modeling was used to identify risk modifiers associated with ARDS, and odds ratios (ORs) and their 95% confidence intervals were reported. The following explanatory variables were then assessed: age, sex, admission source, body mass index, smoking status, congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, steroid use, statin use, infection site, septic shock, and acute physiology and chronic health evaluation (APACHE) II score. After applying inclusion and exclusion criteria, 594 patients with non-pulmonary sepsis were enrolled, among whom 85 (14.3%) had ARDS. Septic shock was diagnosed in 80% of patients with ARDS and 66% of those without ARDS ( Soft tissue infection, ICU admission from an emergency department, and a higher APACHE II score appear to be the risk modifiers of ARDS in patients with non-pulmonary sepsis.
Sections du résumé
BACKGROUND
BACKGROUND
Predisposing conditions and risk modifiers instead of causes and risk factors have recently been used as alternatives to identify patients at a risk of acute respiratory distress syndrome (ARDS). However, data regarding risk modifiers among patients with non-pulmonary sepsis is rare.
METHODS
METHODS
We conducted a secondary analysis of the multicenter, prospective, Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis and Trauma (FORECAST) cohort study that was conducted in 59 intensive care units (ICUs) in Japan during January 2016-March 2017. Adult patients with severe sepsis caused by non-pulmonary infection were included, and the primary outcome was having ARDS, defined as meeting the Berlin definition on the first or fourth day of screening. Multivariate logistic regression modeling was used to identify risk modifiers associated with ARDS, and odds ratios (ORs) and their 95% confidence intervals were reported. The following explanatory variables were then assessed: age, sex, admission source, body mass index, smoking status, congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, steroid use, statin use, infection site, septic shock, and acute physiology and chronic health evaluation (APACHE) II score.
RESULTS
RESULTS
After applying inclusion and exclusion criteria, 594 patients with non-pulmonary sepsis were enrolled, among whom 85 (14.3%) had ARDS. Septic shock was diagnosed in 80% of patients with ARDS and 66% of those without ARDS (
CONCLUSIONS
CONCLUSIONS
Soft tissue infection, ICU admission from an emergency department, and a higher APACHE II score appear to be the risk modifiers of ARDS in patients with non-pulmonary sepsis.
Identifiants
pubmed: 31938547
doi: 10.1186/s40560-020-0426-9
pii: 426
pmc: PMC6954566
doi:
Types de publication
Journal Article
Langues
eng
Pagination
7Investigateurs
Osamu Tasaki
(O)
Yasumitsu Mizobata
(Y)
Hiraku Funakoshi
(H)
Toshiro Okuyama
(T)
Iwao Yamashita
(I)
Toshio Kanai
(T)
Yasuo Yamada
(Y)
Mayuki Aibiki
(M)
Keiji Sato
(K)
Susumu Yamashita
(S)
Susumu Yamashita
(S)
Kenichi Yoshida
(K)
Shunji Kasaoka
(S)
Akihide Kon
(A)
Hiroshi Rinka
(H)
Hiroshi Kato
(H)
Hiroshi Okudera
(H)
Eichi Narimatsu
(E)
Toshifumi Fujiwara
(T)
Manabu Sugita
(M)
Yasuo Shichinohe
(Y)
Hajime Nakae
(H)
Ryouji Iiduka
(R)
Mitsunobu Nakamura
(M)
Yuji Murata
(Y)
Yoshitake Sato
(Y)
Hiroyasu Ishikura
(H)
Yasuhiro Myojo
(Y)
Yasuyuki Tsujita
(Y)
Kosaku Kinoshita
(K)
Hiroyuki Yamaguchi
(H)
Toshihiro Sakurai
(T)
Satoru Miyatake
(S)
Takao Saotome
(T)
Susumu Yasuda
(S)
Toshikazu Abe
(T)
Hiroshi Ogura
(H)
Yutaka Umemura
(Y)
Atsushi Shiraishi
(A)
Shigeki Kushimoto
(S)
Daizoh Saitoh
(D)
Seitaro Fujishima
(S)
Junichi Sasaki
(J)
Toshihiko Mayumi
(T)
Yasukazu Shiino
(Y)
Taka-Aki Nakada
(TA)
Takehiko Tarui
(T)
Toru Hifumi
(T)
Yasuhiro Otomo
(Y)
Joji Kotani
(J)
Yuichiro Sakamoto
(Y)
Shin-Ichiro Shiraishi
(SI)
Kiyotsugu Takuma
(K)
Ryosuke Tsuruta
(R)
Akiyoshi Hagiwara
(A)
Kazuma Yamakawa
(K)
Naoshi Takeyama
(N)
Norio Yamashita
(N)
Hiroto Ikeda
(H)
Yasuaki Mizushima
(Y)
Satoshi Gando
(S)
Informations de copyright
© The Author(s). 2020.
Déclaration de conflit d'intérêts
Competing interestsThe authors declare that they have no competing interests.
Références
Korean J Intern Med. 2019 Jan;34(1):116-124
pubmed: 29898577
Am J Respir Crit Care Med. 2009 Jun 15;179(12):1107-14
pubmed: 19324974
Am J Physiol Lung Cell Mol Physiol. 2005 Jun;288(6):L1026-32
pubmed: 15665042
Crit Care Med. 2005 Jun;33(6):1191-8
pubmed: 15942330
Crit Care Med. 2006 Jan;34(1):22-30
pubmed: 16374152
Crit Care. 2018 Nov 22;22(1):322
pubmed: 30466493
Intensive Care Med. 2011 Dec;37(12):1932-41
pubmed: 21997128
Crit Care Med. 2011 Jan;39(1):40-5
pubmed: 20935560
Crit Care. 2014 Mar 25;18(2):R50
pubmed: 24666941
Respirology. 2016 Jul;21(5):898-904
pubmed: 27028604
Crit Care Med. 2015 Sep;43(9):1790-7
pubmed: 26010690
Am J Respir Crit Care Med. 2011 Feb 15;183(4):462-70
pubmed: 20802164
N Engl J Med. 2000 May 4;342(18):1301-8
pubmed: 10793162
N Engl J Med. 2006 Jun 15;354(24):2564-75
pubmed: 16714767
Transfusion. 2015 May;55(5):947-52
pubmed: 25488517
Crit Care. 2018 Oct 27;22(1):268
pubmed: 30367670
Chest. 2015 Jun;147(6):1539-1548
pubmed: 26033126
Arch Bronconeumol. 2009 Jun;45(6):291-6
pubmed: 19403223
BMJ. 2008 May 3;336(7651):1006-9
pubmed: 18434379
JAMA. 2016 Feb 23;315(8):788-800
pubmed: 26903337
Crit Care. 2012 Jun 19;16(3):223
pubmed: 22713281
Ann Intensive Care. 2017 Dec;7(1):11
pubmed: 28116595
Crit Care Med. 2003 Apr;31(4):1250-6
pubmed: 12682500
N Engl J Med. 2004 Jul 22;351(4):327-36
pubmed: 15269312
PLoS One. 2016 Mar 02;11(3):e0150383
pubmed: 26934369
Thorax. 2010 Jan;65(1):44-50
pubmed: 19770169
N Engl J Med. 2014 Jun 5;370(23):2191-200
pubmed: 24835849
Am J Respir Crit Care Med. 1995 Feb;151(2 Pt 1):293-301
pubmed: 7842182
Crit Care Med. 2000 Jul;28(7):2187-92
pubmed: 10921539
Crit Care Med. 2008 May;36(5):1518-22
pubmed: 18434908
Chest. 2009 Apr;135(4):936-943
pubmed: 19188549
Ann Intern Med. 2004 Mar 2;140(5):338-45
pubmed: 14996675
Minerva Anestesiol. 2010 Jun;76(6):448-54
pubmed: 20473258
Bone Marrow Transplant. 2013 Mar;48(3):452-8
pubmed: 23208313
Crit Care. 2007;11(5):R96
pubmed: 17784960
JAMA. 2012 Jun 20;307(23):2526-33
pubmed: 22797452
Eur Respir J. 2011 Mar;37(3):604-9
pubmed: 20562130
Shock. 2013 Nov;40(5):375-81
pubmed: 23903852
N Engl J Med. 2010 Sep 16;363(12):1107-16
pubmed: 20843245
Lancet. 2009 Oct 17;374(9698):1351-63
pubmed: 19762075
Lancet. 2008 Jan 12;371(9607):126-34
pubmed: 18191684
J Intensive Care. 2019 May 3;7:28
pubmed: 31073407
Crit Care Med. 2017 May;45(5):798-805
pubmed: 28240689
N Engl J Med. 2014 Oct 30;371(18):1695-703
pubmed: 25268516
Intensive Care Med. 2010 Jun;36(6):963-70
pubmed: 20229040