@article{JTD16192,
author = {Jian Luo and He Yu and Yue-Hong Hu and Dan Liu and Yi-Wei Wang and Mao-Yun Wang and Bin-Miao Liang and Zong-An Liang},
title = {Early identification of patients at risk for acute respiratory distress syndrome among severe pneumonia: a retrospective cohort study},
journal = {Journal of Thoracic Disease},
volume = {9},
number = {10},
year = {2017},
keywords = {},
abstract = {Background: Severe pneumonia is the predominant cause for acute respiratory distress syndrome (ARDS). Identification of ARDS from patients with severe pneumonia remains a significant clinical problem due to the overlap of clinical presentations and symptoms. Early recognition of risks for ARDS from severe pneumonia is of great clinical value.
Methods: From April 2014 to December 2015, patients with severe pneumonia at admission were retrieved from the hospital database, of which ARDS developed within 7 days were further identified. We compared the demographic and clinical characteristics at admission between severe pneumonia patients with and without ARDS development, followed by analysis of potential predictors for ARDS development and mortality. Multivariate logistic regression and receiver operating characteristic (ROC) curves were performed to screen independent risk factors and identify their sensitivity in predicting ARDS development and prognosis.
Results: Compared with severe pneumonia without ARDS development, patients with ARDS development had shorter disease duration before admission, higher lung injury score (LIS), serum fibrinogen (FiB), and positive end-expiratory pressure (PEEP), lower Marshall score, sequential organ failure assessment score and proportion of cardiovascular and gastrointestinal diseases, but similar mortality. Serum FiB >5.15 g/L [adjusted odds ratio (OR) 1.893, 95% confidence interval (CI): 1.141–3.142, P=0.014] and PEEP >6.5 cmH2O (adjusted OR 1.651, 95% CI: 1.218–2.237, P=0.001) were independent predictors for ARDS development with a sensitivity of 58.3% and 87.5%, respectively, and pH 6.5 cmH2O and serum FiB >5.15 g/L in severe pneumonia patients, and pH },
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/16192}
}