ARDS: Risk Factors, Prognostic Factors, Management and Outcomes. Incidence and Mortality of ARDS in Combat Casualty Care

摘要

The incidence and mortality of Acute Respiratory Distress Syndrome (ARDS) and utilization of resources for ARDS treatment in current combat casualty care was investigated through a query of the Joint Theater Trauma Registry. Development of ARDS was found to be significantly associated (p =.05) with higher military injury severity scale (ISS), low admission systolic blood pressure (SBP), and female gender. Blast injury was the most common mechanism of injury in ARDS patients but was not confirmed as an independent risk factor for ARDS development. Mortality among ARDS patients was independently associated with higher ISS, low SBP and lower Glasgow Coma Scale and was significantly increased in intubated patients when ARDS was present. Critical care resource utilization was significantly greater for ARDS patients. ARDS still accounts for death in 0.4% of hospitalized casualties in current military medical care. Further investigations of ARDS prevention and evaluation of resuscitation strategies as a risk factor is warranted. Long-term follow up of ARDS survivors in combat casualty is necessary.