Etiologies and Outcomes of Acute Respiratory Failure in Community

November 2, 2005 updated by: National Taiwan University Hospital

Etiologies and Outcomes Analysis of Acute Respiratory Failure in Community

Acute respiratory failure (ARF) remains a common reason for admission to the intensive care unit (ICU). ARF to be present in 32% of patients on ICU admission, with a further 24% of patients developing ARF during the ICU stay. A total of 56% of all ICU admissions for a length of >48 h had ARF at some point during their stay. The incidence of ARF was from 88.6 to 137.1 hospitalizations per 100,000 residents. The incidence of ARF was found to increase nearly exponentially with each decade until age 85 years. However, there is still paucity data about etiology and outcomes of acute respiratory failure happened in community.

Mortality of ARF in critically ill patients is between 40% and 65%. Independent hazards for ARF mortality include older age, severe chronic co-morbidities (HIV, active malignancy, cirrhosis), certain precipitating events (trauma, drug overdose, bone marrow transplant), and multiple organ system failure (MOSF) [7-9]. Mortality has also been associated with acute lung injury or bilateral infiltrates on chest radiograph, and with an elevated acute physiology score.

ARF patients form a large percentage of all ICU admissions and many factors might influence the final outcomes. With the high incidence of ARF in ICU, any improvement in the outcome of such population is likely to have marked effect on intensive care resource allocation. We wish this study may provide some valuable information about acute respiratory failure in community and improve the outcome of these patients.

Study Overview

Status

Unknown

Conditions

Detailed Description

Acute respiratory failure (ARF) remains a common reason for admission to the intensive care unit (ICU). ARF to be present in 32% of patients on ICU admission, with a further 24% of patients developing ARF during the ICU stay [1]. A total of 56% of all ICU admissions for a length of >48 h had ARF at some point during their stay [1]. The incidence of ARF was from 88.6 to 137.1 hospitalizations per 100,000 residents [2, 3]. The incidence of ARF was found to increase nearly exponentially with each decade until age 85 years. However, there is still paucity data about etiology and outcomes of acute respiratory failure happened in community.

Mortality of ARF in critically ill patients is between 40% and 65% [2, 4-6]. Independent hazards for ARF mortality include older age, severe chronic co-morbidities (HIV, active malignancy, cirrhosis), certain precipitating events (trauma, drug overdose, bone marrow transplant), and multiple organ system failure (MOSF) [7-9]. Mortality has also been associated with acute lung injury or bilateral infiltrates on chest radiograph [6], and with an elevated acute physiology score [9-10].

ARF patients form a large percentage of all ICU admissions and many factors might influence the final outcomes. With the high incidence of ARF in ICU, any improvement in the outcome of such population is likely to have marked effect on intensive care resource allocation. We wish this study may provide some valuable information about acute respiratory failure in community and improve the outcome of these patients.

References:

  1. Vincent JL, Akca S, De Mendonca A, et al: The epidemiology of acute respiratory failure in critically ill patients. Chest 2002; 121:1602-1609
  2. Lewandowski K, Mets J, Deutschmann H, et al. Incidence, severity, and mortality of acute respiratory failure in Berlin, Germany. Am J Respir Crit Care Med 1995; 151:1121-1125
  3. Behrendt CE. Acute respiratory failure in the United States: incidence and 31-day survival. Chest 2000; 118:1100-1105
  4. Miberg JA, Davis DR, Steinberg KP, et al. Improved survival of patients with acute respiratory distress syndrome (ARDS): 1983-1993. JAMA 1995; 273:306-309
  5. Doyle LA, Szaflarski N, Modin GW, et al. Identification of patients with acute lung injury: predictors of mortality. Am J Respir Crit Care Med 1995; 152:1818-1824
  6. Luhr OR, Antonsen K, Karlsson M, et al. Incidence and mortality after acute respiratory failure and acute respiratory distress syndrome in Sweden, Denmark, and Iceland: The ARF Study Group. Am J Respir Crit Care Med 1999; 159:1849-1861
  7. Vasilyev S, Schaap RN, Mortensen JD. Hospital survival rates of patients with acute respiratory failure in modern respiratory intensive care units. Chest 1995; 107:1083-1088
  8. Stauffer JL, Fayter NA, Graves B, et al. Survival following mechanical ventilation for acute respiratory failure in adult men. Chest 1993; 104:1222-1229
  9. Knaus WA. Prognosis with mechanical ventilation: the influence of disease, severity of disease, age, and chronic health status on survival from an acute illness. Am Rev Respir Dis 1989; 140:S8-S13
  10. Epstein SK, Vuong V. Lack of influence of gender on outcomes of mechanically ventilated medical ICU patients. Chest 1999; 116:732-739

Study Type

Observational

Enrollment

150

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Taiwan
      • Taipei, Taiwan
        • Recruiting
        • National Taiwan University Hospital
        • Contact:
        • Contact:
        • Principal Investigator:
          • Chia-Lin Hsu, MD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Acute respiratory failure with mechanical ventilation
  • Respiratory failure happened within 48 hours after admission
  • Age > 18 y/o

Exclusion Criteria:

  • Pregnanacy
  • Transfer from other hospital with mechanical ventilation
  • Mechanical ventilation after scheduled operation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Taiwan University Hospital

Investigators

  • Principal Investigator: Chia-Lin Hsu, MD, Physcian

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

August 1, 2005

Study Completion

February 1, 2006

Study Registration Dates

First Submitted

September 13, 2005

First Submitted That Met QC Criteria

September 14, 2005

First Posted (Estimate)

September 15, 2005

Study Record Updates

Last Update Posted (Estimate)

November 3, 2005

Last Update Submitted That Met QC Criteria

November 2, 2005

Last Verified

July 1, 2005

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 9461700726

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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