关键词: 呼吸窘迫综合征；急性病生理学和长期健康评价；脓毒症；预后

Abstract:

Objective   To investigate the risk factors influencing the outcomes of patients with acute respiratory distress syndrome (ARDS). Methods   The clinical data of 145 patients from January 2008 to January 2011 were retrospectively analyzed. The patients were divided into the survivor group (n=80) and the non-survivor group (n=65). The age, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) score, sequential organ failure assessment (SOFA)  score, the number of dysfunctional organs, sepsis severity, ARDS originating from pulmonary disease (ARDSp) and extra-pulmonary disease (ARDSexp) were analyzed to evaluate the prognosis. Results   Univariate analysis showed that the age (P＜0.001), APACHEⅡ score (P＜0.001), SOFA score (P=0.003), number of dysfunctional organs (P＜0.001), sepsis severity (P＜0.001), ARDSp and ARDSexp (P=0.043), and anticoagulant application (P=0.006) had significant differences between the survivor group and the non-survivor group. Logistic regression analysis showed that APACHEⅡ(P=0.016, OR: 1.095, 95% CI: 1.0171.179), sepsis severity (P＜0.001, OR: 2.559, 95%CI: 1.6094.072), and ARDSp and ARDSexp (P=0.033, OR: 0.348, 95% CI: 0.1310.920) were the independent predictors of the mortality in patients with ARDS. Conclusion   The APACHEⅡ scores, sepsis severity, and ARDS origin are the independent predictors of mortality in patients with ARDS.

Key words: Respiratory distress syndrome； APACHE； Sepsis； Prognosis