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This Article Full Text (PDF) All Versions of this Article: chest.07-2134v1 133/5/1120    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Zambon, M. Articles by Vincent, J.-L. Search for Related Content PubMed PubMed Citation Articles by Zambon, M. Articles by Vincent, J.-L.

Mortality rates for patients with ALI/ARDS have decreased over time

Dept of Intensive Care, Erasme Hospital, Université libre de Bruxelles, Belgium

jlvincen{at}ulb.ac.be

Abstract

Background Over the last decade, several studies have suggested that survival rates for patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) may have improved. We performed a systematic analysis of the ALI/ARDS literature to document possible trends in mortality between 1994 and 2006.

Methods We used the Medline database to select studies with the keywords "acute lung injury", "acute respiratory distress syndrome", "acute respiratory failure", "mechanical ventilation". All studies that reported mortality for patients with ALI/ARDS defined according to the criteria of the American European Consensus Conference were selected. We excluded studies with less than 30 patients and studies limited to specific subgroups of ARDS patients, such as sepsis, trauma, burns or transfusion-related ARDS.

Results Seventy-two studies were included in the analysis. There was a wide variation in mortality rates among the studies, from 15-72%. The overall pooled mortality rate for all studies was 43% (95% CI 40-46%). Meta-regression analysis suggested a significant decrease in overall mortality rates of approximately 1.1% per year over the period analyzed (1994-2006). The mortality reduction was also observed for hospital but not for ICU or 28-day mortality.

Conclusions In this literature review, the data are consistent with a reduction in mortality rates in general populations of patients with ALI/ARDS over the last 10 years.

Key Words: acute respiratory failure • hypoxemia • literature review • outcomes