Acute respiratory failure in the United States - Incidence and 31-day survival
Acute respiratory failure in the United States - Incidence and 31-day survival
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DOI：
10.1378/chest.118.4.1100
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发表时间：
2000-10-01
期刊：
影响因子：
9.6
通讯作者：
Behrendt, CE
中科院分区：
文献类型：
--
作者：
Behrendt, CE
研究目标：估计美国急性呼吸衰竭 (ARF) 的发病率，并分析一组 ARF 患者的 31 天住院死亡率。设计背景：回顾性队列是从 1994 年 904 家代表性非联邦医院的 640 万名出院患者的全国住院患者样本中抽取的。患者：样本中的所有 61,223 名患者，其出院记录显示以下所有情况：急性呼吸窘迫或衰竭、机械通气、>住院24小时，年龄大于或等于5岁。结果：估计1994年全国非联邦医院出院的患者有329,766名符合ARF的研究标准，ARF的发生率为每100,000名年龄大于或等于5岁的美国居民中有137.1人住院。直到 85 岁，发病率每十年几乎呈指数级增长。总体而言，35.9% 的 ARF 患者未能存活至出院。 31天时，医院死亡率为31.4%，根据比例风险模型，显着的死亡风险包括年龄（大于或等于80岁且大于或等于30岁）、多器官系统衰竭（MOSF）、HIV、慢性肝病和癌症。因冠状动脉搭桥、药物过量或头部受伤或烧伤以外的创伤而入院与死亡风险降低相关。年龄与 MOSF、创伤和癌症之间存在相互作用。源自危险模型的评分系统将患者分为七组，其 31 天生存概率从 24% 到 99% 不等。结论：ARF 的发病率随着年龄的增长而显着增加，在 65 岁以上的人群中尤其高。非肺部危害解释了短期（31 天）存活率。
Study objectives: To estimate the incidence of acute respiratory failure (ARF) in the United States and to analyze 31-day hospital mortality among a cohort of patients with ARF,Design ann setting: Retrospective cohort drawn from the Nationwide Inpatient Sample of 6.4 million discharges from 904 representative nonfederal hospitals during 1994.Patients: All 61,223 patients in the sample whose discharge records indicated all of the following: acute respiratory distress or failure, mechanical ventilation, > 24 h of hospitalization, and age greater than or equal to5 years.Results: An estimated 329,766 patients discharged from nonfederal hospitals nationwide in 1994 met study criteria for ARF, The incidence of ARF was 137.1 hospitalizations per 100,000 US residents age greater than or equal to5 years. Incidence increased nearly exponentially each decade until age 85 years. Overall, 35.9% of patients with ARF did not survive to hospital discharge. At 31 days, hospital mortality was 31.4%, According to the proportional hazards model, significant mortality hazards included age (greater than or equal to 80 years and greater than or equal to 30 years), multiorgan system failure (MOSF), HIV, chronic liver disease, and cancer. Hospital admission for coronary artery bypass, drug overdose, or trauma other than head injury or burns was associated with a reduced mortality hazard. Interaction was present between age and MOSF, trauma, and cancer. A point system derived from the hazard model classified patients into seven groups with distinct 31-day survival probabilities ranging from 24 to 99%.Conclusions: The incidence of ARF increases markedly with age and is especially high among persons greater than or equal to 65 years of age. Nonpulmonary hazards explain short-term (31-day) survival.