High‐resolution computed tomography for the prediction of mortality in acute respiratory distress syndrome: A retrospective cohort study

BACKGROUND AND AIMS: Acute respiratory distress syndrome (ARDS) demonstrates several image patterns on high‐resolution computed tomography (HRCT). The purpose of this study was to investigate the relationship between specific HRCT findings and the prognosis of ARDS. METHODS: This was a retrospective cohort study performed in a single hospital in Japan. We categorized HRCT findings into three distribution patterns: diffuse, subpleural sparing, and dorsal patterns. All patterns were assessed at three levels of each lung. Multivariable logistic regression analysis was used to identify parameters associated with in‐hospital mortality. RESULTS: A total of 144 patients with ARDS (age: 72 ± 16 years, 112 men) were included in the study. The in‐hospital mortality rate was 42% (survivors, n = 83; nonsurvivors, n = 61). Nonsurvivors were significantly older (70 ± 17 vs 76 ± 13, P = 0.01) and had lower serum albumin levels (P = 0.01), more traction bronchiectasis (P = 0.02), and more diffuse pattern (P < 0.001) than survivors. The presence of diffuse patterns was an independent adverse prognostic factor for predicting mortality (odds ratio, 1.32; 95% confidence interval [CI]: 1.08‐1.61, P = 0.007). CONCLUSIONS: HRCT distribution patterns may predict mortality in ARDS patients.