Etiologies and Outcomes of Acute Respiratory Failure in Community

NCT ID: NCT00174070

Last Updated: 2005-11-03

Basic Information

• Recruitment Status: UNKNOWN
• Total Enrollment: 150 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2005-08-31
• Study Completion Date: 2006-02-28

Brief Summary

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.

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

Conditions

Respiratory Failure

Keywords

Respiratory failure; Community

Study Design

• Observational Model Type: DEFINED_POPULATION
• Study Time Perspective: OTHER

Eligibility Criteria

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

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Taiwan University Hospital

OTHER

Sponsor Role: lead

Principal Investigators

Chia-Lin Hsu, MD

Role: PRINCIPAL_INVESTIGATOR

Physcian

Locations

National Taiwan University Hospital

Taipei, , Taiwan

Site Status: RECRUITING

Countries

Taiwan

Central Contacts

Chia-Lin Hsu, MD

Role: CONTACT

Phone: 886-2-23123456-2905

Email: cls7@ha.mc.ntu.edu,tw

Facility Contacts

Chial-Lin Hsu, MD

Role: primary

Jih-Shuin Jerng, MD

Role: backup

References

Vincent JL, Akca S, De Mendonca A, Haji-Michael P, Sprung C, Moreno R, Antonelli M, Suter PM; SOFA Working Group. Sequntial organ failure assessment. The epidemiology of acute respiratory failure in critically ill patients(*). Chest. 2002 May;121(5):1602-9. doi: 10.1378/chest.121.5.1602.

Reference Type: BACKGROUND

PMID: 12006450 (View on PubMed)

Lewandowski K, Metz J, Deutschmann C, Preiss H, Kuhlen R, Artigas A, Falke KJ. Incidence, severity, and mortality of acute respiratory failure in Berlin, Germany. Am J Respir Crit Care Med. 1995 Apr;151(4):1121-5. doi: 10.1164/ajrccm.151.4.7697241.

Reference Type: BACKGROUND

PMID: 7697241 (View on PubMed)

Behrendt CE. Acute respiratory failure in the United States: incidence and 31-day survival. Chest. 2000 Oct;118(4):1100-5. doi: 10.1378/chest.118.4.1100.

Reference Type: BACKGROUND

PMID: 11035684 (View on PubMed)

Milberg JA, Davis DR, Steinberg KP, Hudson LD. Improved survival of patients with acute respiratory distress syndrome (ARDS): 1983-1993. JAMA. 1995 Jan 25;273(4):306-9.

Reference Type: BACKGROUND

PMID: 7815658 (View on PubMed)

Doyle RL, Szaflarski N, Modin GW, Wiener-Kronish JP, Matthay MA. Identification of patients with acute lung injury. Predictors of mortality. Am J Respir Crit Care Med. 1995 Dec;152(6 Pt 1):1818-24. doi: 10.1164/ajrccm.152.6.8520742.

Reference Type: BACKGROUND

PMID: 8520742 (View on PubMed)

Luhr OR, Antonsen K, Karlsson M, Aardal S, Thorsteinsson A, Frostell CG, Bonde J. 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 Jun;159(6):1849-61. doi: 10.1164/ajrccm.159.6.9808136.

Reference Type: BACKGROUND

PMID: 10351930 (View on PubMed)

Vasilyev S, Schaap RN, Mortensen JD. Hospital survival rates of patients with acute respiratory failure in modern respiratory intensive care units. An international, multicenter, prospective survey. Chest. 1995 Apr;107(4):1083-8. doi: 10.1378/chest.107.4.1083.

Reference Type: BACKGROUND

PMID: 7705120 (View on PubMed)

Stauffer JL, Fayter NA, Graves B, Cromb M, Lynch JC, Goebel P. Survival following mechanical ventilation for acute respiratory failure in adult men. Chest. 1993 Oct;104(4):1222-9. doi: 10.1378/chest.104.4.1222.

Reference Type: BACKGROUND

PMID: 8404197 (View on PubMed)

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 Aug;140(2 Pt 2):S8-13. doi: 10.1164/ajrccm/140.2_Pt_2.S8.

Reference Type: BACKGROUND

PMID: 2669589 (View on PubMed)

Epstein SK, Vuong V. Lack of influence of gender on outcomes of mechanically ventilated medical ICU patients. Chest. 1999 Sep;116(3):732-9. doi: 10.1378/chest.116.3.732.

Reference Type: BACKGROUND

PMID: 10492280 (View on PubMed)

Other Identifiers

9461700726

Identifier Type: -

Identifier Source: org_study_id