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Acute respiratory distress syndrome after bacteremic sepsis does not increase mortality

Ferriere, Karin
Published in American Journal of Respiratory and Critical Care Medicine. 2003, vol. 167, no. 9, p. 1210-1214
Abstract To determine whether acute respiratory distress syndrome (ARDS) complicating bacteremic sepsis independently affects mortality in critically ill patients, we conducted a 3-year retrospective cohort study in a surgical intensive care unit. We included all consecutive patients with blood culture-positive sepsis and measured organ dysfunctions and mortality. Among 4,530 admissions, 196 cases of bacteremic sepsis were recorded. ARDS occurred in 31 (16%) of these patients. The case fatality rate was 58% in patients with ARDS compared with 31% in patients without ARDS. Using Cox proportional hazards regression with time-dependent variables, the unadjusted hazard ratio for death was 1.8 (95% confidence interval [CI], 1.0-3.2). After adjusting for comorbid factors that were present before the onset of sepsis, the hazard ratio was 2.2 (95% CI, 1.2-3.9). After further adjustment was made for nonpulmonary organ dysfunctions and microbiologic factors that were independently associated with mortality, the adjusted hazard ratio for ARDS was 0.6 (95% CI, 0.3-1.2). Among critically ill surgical patients, ARDS complicating bacteremic sepsis remains common, but it is not independently associated with short-term mortality, after adjusting for severity of illness and nonpulmonary organ dysfunctions evolving after the onset of sepsis.
Keywords ApacheAcute DiseaseAgedAnalysis of VarianceBacteremia/blood/ complications/ mortalityCause of DeathComorbidityCritical IllnessFemaleHospital MortalityHospitals, UniversityHumansLength of Stay/statistics & numerical dataMaleMiddle AgedPrognosisProportional Hazards ModelsRespiratory Distress Syndrome, Adult/ microbiologyRetrospective StudiesRisk FactorsSeverity of Illness IndexSurvival AnalysisSwitzerland/epidemiology
PMID: 12615616
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Other version: http://ajrccm.atsjournals.org/cgi/reprint/167/9/1210.pdf
Research groups Epidémiologie et contrôle de la résistance aux antibiotiques (866)
Staphylocoques dorés résistants à la méthicilline et hygiène hospitalière (330)
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EGGIMANN, Philippe et al. Acute respiratory distress syndrome after bacteremic sepsis does not increase mortality. In: American Journal of Respiratory and Critical Care Medicine, 2003, vol. 167, n° 9, p. 1210-1214. doi: 10.1164/rccm.200210-1196OC https://archive-ouverte.unige.ch/unige:7179

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Deposited on : 2010-06-21

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