Cargando…
Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy
BACKGROUND: Diffuse alveolar damage (DAD) is a typical pathological finding of open lung biopsies in patients with acute respiratory distress syndrome (ARDS). Patients with ARDS and DAD have been reported to have a poorer prognosis than those without DAD. The aim of this study was to investigate the...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497963/ https://www.ncbi.nlm.nih.gov/pubmed/28678876 http://dx.doi.org/10.1371/journal.pone.0180018 |
_version_ | 1783248227315744768 |
---|---|
author | Kao, Kuo-Chin Chang, Chih-Hao Hung, Chen-Yiu Chiu, Li-Chung Huang, Chung-Chi Hu, Han-Chung |
author_facet | Kao, Kuo-Chin Chang, Chih-Hao Hung, Chen-Yiu Chiu, Li-Chung Huang, Chung-Chi Hu, Han-Chung |
author_sort | Kao, Kuo-Chin |
collection | PubMed |
description | BACKGROUND: Diffuse alveolar damage (DAD) is a typical pathological finding of open lung biopsies in patients with acute respiratory distress syndrome (ARDS). Patients with ARDS and DAD have been reported to have a poorer prognosis than those without DAD. The aim of this study was to investigate the survival predictors in patients with ARDS and DAD. METHODS: We retrospectively reviewed all ARDS patients who underwent an open lung biopsy which showed evidence of DAD from January 2006 to June 2015 at Chang Gung Memorial Hospital. Clinical data including baseline characteristics, medication, and survival outcomes were analyzed. RESULTS: A total of 64 ARDS patients with DAD were eligible for analysis and divided into known etiology (n = 17, 26.6%) and unknown etiology groups (n = 47, 73.4%). There was no significant difference in hospital mortality rate between the two groups (71.9% vs. 70.6%, p = 0.890). Univariate logistic regression analysis revealed that sequential organ failure assessment (SOFA) score at the time of a diagnosis of ARDS, and SOFA score, PaO(2)/FiO(2) ratio, and positive end expiratory pressure level when the biopsy was performed were associated with hospital mortality. Multivariate analysis showed that the SOFA score on the day of the biopsy was an independent predictor of hospital mortality (odds ratio 1.413, 95% confidence interval 1.127–1.772; p = 0.03). There were no significant differences in the use, dose, duration and timing from ARDS to glucocorticoid therapy between the survivors and nonsurvivors. CONCLUSION: For selected ARDS patients who underwent an open lung biopsy with pathological DAD, SOFA score was an independent predictor of hospital mortality. |
format | Online Article Text |
id | pubmed-5497963 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-54979632017-07-25 Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy Kao, Kuo-Chin Chang, Chih-Hao Hung, Chen-Yiu Chiu, Li-Chung Huang, Chung-Chi Hu, Han-Chung PLoS One Research Article BACKGROUND: Diffuse alveolar damage (DAD) is a typical pathological finding of open lung biopsies in patients with acute respiratory distress syndrome (ARDS). Patients with ARDS and DAD have been reported to have a poorer prognosis than those without DAD. The aim of this study was to investigate the survival predictors in patients with ARDS and DAD. METHODS: We retrospectively reviewed all ARDS patients who underwent an open lung biopsy which showed evidence of DAD from January 2006 to June 2015 at Chang Gung Memorial Hospital. Clinical data including baseline characteristics, medication, and survival outcomes were analyzed. RESULTS: A total of 64 ARDS patients with DAD were eligible for analysis and divided into known etiology (n = 17, 26.6%) and unknown etiology groups (n = 47, 73.4%). There was no significant difference in hospital mortality rate between the two groups (71.9% vs. 70.6%, p = 0.890). Univariate logistic regression analysis revealed that sequential organ failure assessment (SOFA) score at the time of a diagnosis of ARDS, and SOFA score, PaO(2)/FiO(2) ratio, and positive end expiratory pressure level when the biopsy was performed were associated with hospital mortality. Multivariate analysis showed that the SOFA score on the day of the biopsy was an independent predictor of hospital mortality (odds ratio 1.413, 95% confidence interval 1.127–1.772; p = 0.03). There were no significant differences in the use, dose, duration and timing from ARDS to glucocorticoid therapy between the survivors and nonsurvivors. CONCLUSION: For selected ARDS patients who underwent an open lung biopsy with pathological DAD, SOFA score was an independent predictor of hospital mortality. Public Library of Science 2017-07-05 /pmc/articles/PMC5497963/ /pubmed/28678876 http://dx.doi.org/10.1371/journal.pone.0180018 Text en © 2017 Kao et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kao, Kuo-Chin Chang, Chih-Hao Hung, Chen-Yiu Chiu, Li-Chung Huang, Chung-Chi Hu, Han-Chung Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy |
title | Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy |
title_full | Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy |
title_fullStr | Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy |
title_full_unstemmed | Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy |
title_short | Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy |
title_sort | survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5497963/ https://www.ncbi.nlm.nih.gov/pubmed/28678876 http://dx.doi.org/10.1371/journal.pone.0180018 |
work_keys_str_mv | AT kaokuochin survivalpredictorinpatientswithacuterespiratorydistresssyndromeanddiffusealveolardamageundergoingopenlungbiopsy AT changchihhao survivalpredictorinpatientswithacuterespiratorydistresssyndromeanddiffusealveolardamageundergoingopenlungbiopsy AT hungchenyiu survivalpredictorinpatientswithacuterespiratorydistresssyndromeanddiffusealveolardamageundergoingopenlungbiopsy AT chiulichung survivalpredictorinpatientswithacuterespiratorydistresssyndromeanddiffusealveolardamageundergoingopenlungbiopsy AT huangchungchi survivalpredictorinpatientswithacuterespiratorydistresssyndromeanddiffusealveolardamageundergoingopenlungbiopsy AT huhanchung survivalpredictorinpatientswithacuterespiratorydistresssyndromeanddiffusealveolardamageundergoingopenlungbiopsy |