Reclassifying severity after 48 hours could better predict mortality in acute respiratory distress syndrome

• Published in: Therapeutic advances in respiratory disease 2020, Vol.14, p.1753466620936877-1753466620936877
• Main Authors: Chiu, Li-Chung, Lin, Shih-Wei, Liu, Pi-Hua, Chuang, Li-Pang, Chang, Chih-Hao, Hung, Chen-Yiu, Li, Shih-Hong, Lee, Chung-Shu, Wu, Huang-Pin, Huang, Chung-Chi, Li, Hsin-Hsien, Kao, Kuo-Chin, Hu, Han-Chung
• Format: Article
• Language: English
• Subjects: Mortality; Original Research; Respiratory distress syndrome
• ISSN: 1753-4666; 1753-4658; 1753-4666
• DOI: 10.1177/1753466620936877

Background: Disease severity may change in the first week after acute respiratory distress syndrome (ARDS) onset. The aim of this study was to evaluate whether the reclassification of disease severity after 48 h (i.e. day 3) of ARDS onset could help in predicting mortality and determine factors associated with ARDS persistence and mortality. Methods: We performed a secondary analysis of a 3-year prospective, observational cohort study of ARDS in a tertiary care referral center. Disease severity was reclassified after 48 h of enrollment, and cases that still fulfilled the Berlin criteria were regarded as nonresolving ARDS. Results: A total of 1034 ARDS patients were analyzed. Overall hospital mortality was 57.7% (56.7%, 57.5%, and 58.6% for patients with initial mild, moderate, and severe ARDS, respectively, p = 0.189). On day 3 reclassification, the hospital mortality rates were as follows: resolved (42.1%), mild (47.9%), moderate (62.4%), and severe ARDS (76.1%) (p