Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/333
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DC Field | Value | Language |
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dc.contributor.author | Moran, J. | - |
dc.contributor.author | Solomon, P. | - |
dc.contributor.author | Fox, V. | - |
dc.contributor.author | Salagaras, M. | - |
dc.contributor.author | Williams, P. | - |
dc.contributor.author | Quinlan, K. | - |
dc.contributor.author | Bersten, A. | - |
dc.date.issued | 2004 | - |
dc.identifier.citation | Anaesthesia and Intensive Care, 2004; 32(3):317-329 | - |
dc.identifier.issn | 0310-057X | - |
dc.identifier.issn | 1448-0271 | - |
dc.identifier.uri | http://hdl.handle.net/2440/333 | - |
dc.description | Publisher's copy made available with the permission of the publisher © Australian Society of Anaesthetists | - |
dc.description.abstract | Variables predicting thirty-day outcome from Acute Respiratory Distress Syndrome (ARDS) were analysed using Cox regression structured for time-varying covariates. Over a three-year period, 1996-1998, consecutive patients with ARDS (bilateral chest X-ray opacities, PaO₂/FiO₂ ratio of <200 and an acute precipitating event) were identified using a prospective computerized data base in a university teaching hospital ICU. The cohort, 106 mechanically ventilated patients, was of mean (SD) age 63.5 (15.5) years and 37% were female. Primary lung injury occurred in 45% and 24% were postoperative. ICU-admission day APACHE II score was 25 (8); ARDS onset time from ICU admission was 1 day (median: range 0-16) and 30 day mortality was 41% (95% CI: 33%-51%). At ARDS onset, PaO₂/FiO₂ ratio was 92 (31), 81% had four-quadrant chest X-ray opacification and lung injury score was 2.75 (0.45). Average mechanical ventilator tidal volume was 10.3 ml/ predicted kg weight. Cox model mortality predictors (hazard ratio, 95% CI) were: APACHE II score, 1.15 (1.09-1.21); ARDS lag time (days), 0.72 (0.58-0.89); direct versus indirect injury, 2.89 (1.45-5.76); PaO₂/FiO₂ ratio, 0.98 (0.97-0.99); operative versus non-operative category, 0.24 (0.09-0.63). Time-varying effects were evident for PaO₂/FiO₂ ratio, operative versus non-operative category and ventilator tidal volume assessed as a categorical predictor with a cut-point of 8 ml/kg predicted weight (mean tidal volumes, 7.1 (1.9) vs 10.7 (1.6) ml/kg predicted weight). Thirty-day survival was improved for patients ventilated with lower tidal volumes. Survival predictors in ARDS were multifactorial and related to patient-injury-time interaction and level of mechanical ventilator tidal volume. | - |
dc.description.statementofresponsibility | J. L. Moran, P. J. Solomon, V. Fox, M. Salagaras, P. J. Williams, K. Quinlan, A. D. Bersten | - |
dc.description.uri | http://www.aaic.net.au/Article.asp?D=2003327 | - |
dc.language.iso | en | - |
dc.publisher | Australian Soc Anaesthetists | - |
dc.source.uri | http://dx.doi.org/10.1177/0310057x0403200304 | - |
dc.subject | Lung | - |
dc.subject | Humans | - |
dc.subject | Radiography | - |
dc.subject | Respiration, Artificial | - |
dc.subject | APACHE | - |
dc.subject | Survival Rate | - |
dc.subject | Proportional Hazards Models | - |
dc.subject | Adult | - |
dc.subject | Middle Aged | - |
dc.subject | Intensive Care Units | - |
dc.subject | Female | - |
dc.subject | Male | - |
dc.subject | Respiratory Distress Syndrome | - |
dc.title | Modelling thirty-day mortality in the acute respiratory distress syndrome (ARDS) in an adult ICU | - |
dc.type | Journal article | - |
dc.identifier.doi | 10.1177/0310057x0403200304 | - |
pubs.publication-status | Published | - |
dc.identifier.orcid | Moran, J. [0000-0003-2311-0440] | - |
dc.identifier.orcid | Solomon, P. [0000-0002-0667-6947] | - |
dc.identifier.orcid | Williams, P. [0000-0002-3948-5573] | - |
Appears in Collections: | Anaesthesia and Intensive Care publications Applied Mathematics publications Aurora harvest 2 |
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