Kripti Hartini1, Zulkifli Amin2, Ceva W. Pitoyo2, Cleopas Martin Rumende2
1Departemen Ilmu Penyakit Dalam FKUI/RSCM
2Divisi Respirologi dan Perawatan Penyakit Kritis, Departemen Ilmu Penyakit Dalam FKUI/RSCM
ABSTRACT
Background: Acute respiratory distress syndrome (ARDS) is an emergency in respirology field that contributes to high mortality rate. To decrease the mortality rate of ARDS patients, we need to identify factors affecting it. Studies about factors affecting ARDS mortality showed varying results and until now there is still no comprehensive study about it in Indonesia especially at Cipto Mangunkusumo National hospital (RSCM).
Objective: To analyze factors affecting mortality of ARDS patients at Cipto Mangunkusumo Hospital.
Methods: This study was a retrospective cohort on ARDS patients who were hospitalized in Cipto Mangunkusumo hospital within 2008 and 2012. Data about clinical condition, laboratory, chest X-ray, and outcome of hospitalization were all collected from medical records. Bivariate analysis were performed on age, ARDS etiology, comorbidity Charlson index, PaO2/FiO2 ratio, APACHE II score, and ventilator use in the first 48 hours since ARDS diagnosed.
Multivariate with logistic regression would be done to variables that fulfilled the condition.
Results: A total of 368 patients were included in this study. Inhospital mortality was 75.3%. On bivariate analysis we found that age, ARDS’ etiologies, comorbidity Charlson index, PaO2/FiO2 ratio, APACHE II score, and ventilator use in the first 48 hours since ARDS was diagnosed were variables that had significant associations with inhospital mortality. From multivariate analysis, we found variables that had associations with mortality were sepsis (RR 1.26; 95% CI 1.20-1.32; p < 0.001), the high APACHE II score (RR 1.19; 95% CI 1.04-1.30; p = 0.019) ,and no ventilator use in the first 48 hours since ARDS was diagnosed (RR 1.37; 95% CI 1.25-1.43; p < 0.001).
Conclusions: Sepsis, high APACHE II score, and no ventilator use in the first 48 hours since ARDS was diagnosed were independent factors affecting ARDS patients mortality.
Key words: acute respiratory distress syndrome, factors affecting mortality
