Incidence and outcomes of acute lung injury
Incidence and outcomes of acute lung injury
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DOI：
10.1056/nejmoa050333
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发表时间：
2005-10-20
影响因子：
158.5
通讯作者：
Hudson, LD
中科院分区：
文献类型：
--
作者：
Rubenfeld, GD;Caldwell, E;Hudson, LD
背景：急性肺损伤是一种危重病综合征，由急性低氧性呼吸衰竭和双侧肺浸润性病变组成，不是由左房高压引起的。方法：1999年4月至2000年7月，我们在华盛顿州金县及周边的21家医院进行了一项前瞻性、基于人群的队列研究，采用有效的筛查方案来确定符合急性肺损伤标准的患者。结果：共有1113名金县居民符合急性肺损伤的诊断标准，年龄在15岁或以上。根据这一数字，急性肺损伤的粗发病率为78.9/10万人年，年龄调整后的发病率为86.2/10万人年。住院死亡率为38.5%。急性肺损伤的发生率随着年龄的增长而增加，从15至19岁的16/10万人年增加到75至84岁的306/10万人年。死亡率随年龄增长而增加，15-19岁患者死亡率为24%，85岁及以上患者死亡率为60%(P
BACKGROUND:Acute lung injury is a critical illness syndrome consisting of acute hypoxemic respiratory failure with bilateral pulmonary infiltrates that are not attributed to left atrial hypertension. Despite recent advances in our understanding of the mechanism and treatment of acute lung injury, its incidence and outcomes in the United States have been unclear.METHODS:We conducted a prospective, population-based, cohort study in 21 hospitals in and around King County, Washington, from April 1999 through July 2000, using a validated screening protocol to identify patients who met the consensus criteria for acute lung injury.RESULTS:A total of 1113 King County residents undergoing mechanical ventilation met the criteria for acute lung injury and were 15 years of age or older. On the basis of this figure, the crude incidence of acute lung injury was 78.9 per 100,000 person-years and the age-adjusted incidence was 86.2 per 100,000 person-years. The in-hospital mortality rate was 38.5 percent. The incidence of acute lung injury increased with age from 16 per 100,000 person-years for those 15 through 19 years of age to 306 per 100,000 person-years for those 75 through 84 years of age. Mortality increased with age from 24 percent for patients 15 through 19 years of age to 60 percent for patients 85 years of age or older (P