Trends and Geographic Variation in Acute Respiratory Failure and ARDS Mortality in the United States.
Trends and Geographic Variation in Acute Respiratory Failure and ARDS Mortality in the United States.
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DOI：
10.1016/j.chest.2020.10.042
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发表时间：
2021-04
期刊：
影响因子：
9.6
通讯作者：
Arora P
中科院分区：
文献类型：
--
作者：
Parcha V;Kalra R;Bhatt SP;Berra L;Arora G;Arora P
尽管在急性呼吸衰竭（ARF）和ARDS的病理生理学、进展和管理方面取得了许多进展，但美国关于ARF和ARDS死亡率负担的当代数据有限。美国ARF和ARDS相关死亡率的当代趋势和地理差异是什么？对美国国家卫生统计中心的全国死亡率数据进行了回顾性分析，以评估2014年至2018年ARF和ARDS相关死亡率趋势以及2018年所有美国居民ARF和ARDS相关死亡的地理分布。分段线性回归用于评估总人口和年龄、性别、种族、城市化和地区的各种人口统计学亚组中年龄调整死亡率（AAMR）的趋势。在研究期间的1，434，349例ARF相关死亡和52，958例ARDS相关死亡中，AAMR在老年人（≥ 65岁）、非西班牙裔黑人和居住在非大都市地区的人群中最高。ARF相关死亡的AAMR（每10万人）从2014年的74.9（95%CI，74.6-75.2）增加到2018年的85.6（95%CI，85.3-85.9）（年百分比变化[APC]，3.4 [95%CI，2.2-4.6]; Ptrend = .003）。2014年ARDS相关死亡的AAMR（每10万人）为3.2（95% CI，3.2-3.3），2018年为3.0（95% CI，3.0-3.1; APC，-0.9 [95% CI，-5.4至3.8]; Ptrend = 0.56）。观察到的ARF死亡率的增加在年龄、性别、种族或民族、城市化状况和地理区域的亚组中是一致的（所有P趋势<0.05）。2018年ARF（91.3 [95%CI，90.8-91.8]）和ARDS相关死亡率（3.3 [95%CI，3.2-3.4]）的AAMR（每10万人）在南方最高。ARF相关死亡率每年增加约3.4%，ARDS相关死亡率在过去5年中没有下降。这些数据将重要的健康信息置于背景中，以指导研究，临床护理和政策的优先事项，特别是在美国2019年冠状病毒病大流行期间。
Despite numerous advances in the understanding of the pathophysiology, progression, and management of acute respiratory failure (ARF) and ARDS, limited contemporary data are available on the mortality burden of ARF and ARDS in the United States. What are the contemporary trends and geographic variation in ARF and ARDS-related mortality in the United States? A retrospective analysis of the National Center for Health Statistics’ nationwide mortality data was conducted to assess the ARF and ARDS-related mortality trends from 2014 through 2018 and the geographic distribution of ARF and ARDS-related deaths in 2018 for all American residents. Piecewise linear regression was used to evaluate the trends in age-adjusted mortality rates (AAMRs) in the overall population and various demographic subgroups of age, sex, race, urbanization, and region. Among 1,434,349 ARF-related deaths and 52,958 ARDS-related deaths during the study period, the AAMR was highest in older individuals (≥ 65 years), non-Hispanic Black people, and those living in the nonmetropolitan region. The AAMR for ARF-related deaths (per 100,000 people) increased from 74.9 (95% CI, 74.6-75.2) in 2014 to 85.6 (95% CI, 85.3-85.9) in 2018 (annual percentage change [APC], 3.4 [95% CI, 2.2-4.6]; Ptrend = .003). The AAMR (per 100,000 people) for ARDS-related deaths was 3.2 (95% CI, 3.2-3.3) in 2014 and 3.0 (95% CI, 3.0-3.1 in 2018; APC, −0.9 [95% CI, −5.4 to 3.8]; Ptrend = .56). The observed increase in rates for ARF mortality was consistent across the subgroups of age, sex, race or ethnicity, urbanization status, and geographical region (Ptrend < .05 for all). The AAMR (per 100,000 people) for ARF (91.3 [95% CI, 90.8-91.8]) and ARDS-related mortality (3.3 [95% CI, 3.2-3.4]) in 2018 were highest in the South. The ARF-related mortality increased at approximately 3.4% annually, and ARDS-related mortality showed a lack of decline in the last 5 years. These data contextualize important health information to guide priorities for research, clinical care, and policy, especially during the coronavirus disease 2019 pandemic in the United States.
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影响因子：
24.3
作者：
Pelosi, P;D'Onofrio, D;Gattinoni, L
通讯作者：
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影响因子：
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作者：
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DOI：
10.1165/rcmb.2005-0404oc
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影响因子：
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DOI：
10.1164/rccm.201502-0239oc
发表时间：
2015-08-15
影响因子：
24.7
作者：
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