Incidence and Mortality after Acute Respiratory Failure and Acute Respiratory Distress Syndrome in Sweden, Denmark, and Iceland

TLDR

The study aimed to determine the incidence and 90‑day mortality of acute respiratory failure (ARF), acute lung injury (ALI), and acute respiratory distress syndrome (ARDS) through an eight‑week prospective cohort in Sweden, Denmark, and Iceland. The investigators prospectively assessed all ICU admissions ≥15 years in 132 of 150 ICUs between Oct 6 and Nov 30 1997, defining ARF as ≥24 h of intubation and mechanical ventilation and classifying ALI/ARDS per American‑European Consensus criteria, while adjusting incidence for non‑participating ICUs and noting a 11.74‑million‑person population. Among 1,231 ARF patients, 287 ALI and 221 ARDS cases were identified, yielding annual incidences of 77.6, 17.9, and 13.5 per 100,000, with 90‑day mortalities of 41.0 % for ARF (including ALI/ARDS), 42.2 % for ALI alone, and 41.2 % for ARDS.

Abstract

To determine the incidence and 90-d mortality of acute respiratory failure (ARF), acute lung injury (ALI), and the acute respiratory distress syndrome (ARDS), we carried out an 8-wk prospective cohort study in Sweden, Denmark, and Iceland. All intensive care unit (ICU) admissions (n = 13,346) >/= 15 yr of age were assessed between October 6th and November 30th, 1997 in 132 of 150 ICUs with resources to treat patients with intubation and mechanical ventilation (I + MV) >/= 24 h. ARF was defined as I + MV >/= 24 h. ALI and ARDS were defined using criteria recommended by the American-European Consensus Conference on ARDS. Calculation to correct the incidence for unidentified subjects from nonparticipating ICUs was made. No correction for in- or out-migration from the study area was possible. The population in the three countries >/= 15 yr of age was 11.74 million. One thousand two hundred thirty-one ARF patients were included, 287 ALI and 221 ARDS patients were identified. The incidences were for ARF 77.6, for ALI 17.9, and for ARDS 13.5 patients per 100,000/yr. Ninety-day mortality was 41.0% for ARF, including ALI and ARDS patients, 42.2% for ALI not fulfilling ARDS criteria, and 41.2% for ARDS.