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【medical-news】急性肺损伤/ARDS病人死亡率逐渐下降
CHEST. 2008;133(5):1120-1127
Abstract
Background: Over the last decade, several studies have suggested that survival rates for patients with acute lung injury (ALI) or 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 key words “acute lung injury,” “ARDS,” “acute respiratory failure,” and “mechanical ventilation.” All studies that reported mortality rates for patients with ALI/ARDS defined according to the criteria of the American European Consensus Conference were selected. We excluded studies with < 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 (15 to 72%). The overall pooled mortality rate for all studies was 43% (95% confidence interval, 40 to 46%). Metaregression analysis suggested a significant decrease in overall mortality rates of approximately 1.1%/yr over the period analyzed (1994 to 2006). The mortality reduction was also observed for hospital but not for ICU or 28-day mortality rates.
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.
背景: 最近十年来多个研究提示急性肺损伤(ALI) 或ARDS病人存活率得到提高，我们分析了1994-2006年间ALI/ARDS文献系统了解死亡率变化趋势.
方法: 以关键词 “acute lung injury,” “ARDS,” “acute respiratory failure,”和 “mechanical ventilation.”利用Medline数据库挑选有关研究，所有研究中ALI/ARDS死亡率计算以美国欧洲共同会议为标准；排除那些病人数< 30及限于ARDS特定病人如脓毒症、创伤、烧伤或输液相关的ARDS的研究.
结果: 共分析了72项研究，这些研究间死亡率(15-72%)差异较大，所有研究汇总死亡率为43% (95%可信区间 40-46%)；Meta回归分析提示分析期(1994 -2006) 总死亡率显著下降年均接近1.1%，死亡率下降也见于住院患者；而ICU或28天死亡率未呈相同趋势。
结论: 通过文献回顾，获得与最近十年来 ALI/ARDS一般病人死亡率下降相一致的结论 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-03-31 17:14
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