Nonpulmonary risk factors of acute respiratory distress syndrome in patients with septic bacteraemia.
- Author:
Hyunseung NAM
1
;
Seung Hun JANG
;
Yong Il HWANG
;
Joo Hee KIM
;
Ji Young PARK
;
Sunghoon PARK
Author Information
- Publication Type:Original Article
- Keywords: Respiratory distress syndrome, adult; Bacteremia; Organ failure; Sepsis
- MeSH: Bacteremia; Central Nervous System; Hospital Mortality; Humans; Incidence; Intensive Care Units; Medical Records; Mortality; Multivariate Analysis; Pneumonia; Respiratory Distress Syndrome, Adult*; Retrospective Studies; Risk Factors*; Sepsis
- From:The Korean Journal of Internal Medicine 2019;34(1):116-124
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: The relationship between nonpulmonary organ failure and the development of acute respiratory distress syndrome (ARDS) in patients with sepsis has not been well studied. METHODS: We retrospectively reviewed the medical records of patients with septic bacteremia admitted to the medical intensive care unit (ICU) of a tertiary academic hospital between January 2013 and December 2016. RESULTS: The study enrolled 125 patients of median age 73.0 years. Urinary (n = 47), hepatobiliary (n = 30), and pulmonary infections (n = 28) were the most common causes of sepsis; the incidence of ARDS was 17.6%. The total number of nonpulmonary organ failures at the time of ICU admission was higher in patients with ARDS than in those without (p = 0.011), and the cardiovascular, central nervous system (CNS), and coagulation scores were significantly higher in ARDS patients. On multivariate analysis, apart from pneumonia sepsis, the CNS (odds ratio [OR], 1.917; 95% confidence interval [CI], 1.097 to 3.348) and coagulation scores (OR, 2.669; 95% CI, 1.438 to 4.954) were significantly associated with ARDS development. The 28-day and in-hospital mortality rates were higher in those with ARDS than in those without (63.6 vs. 8.7%, p < 0.001; 72.7% vs. 11.7%, p < 0.001), and ARDS development was found to be an independent risk factor for 28-day mortality. CONCLUSIONS: Apart from pneumonia, CNS dysfunction and coagulopathy were significantly associated with ARDS development, which was an independent risk factor for 28-day mortality.
