Clinical phenotypes from fatal cases of acute respiratory distress syndrome caused by pneumonia
Abstract There have been no report of objective clinical characteristics or prognostic factors that predict fatal outcome of acute respiratory distress syndrome (ARDS) since the Berlin definition was published. The aim of this study is to identify clinically available predictors that distinguish bet...
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doaj-10a0ad4de40c4551b2289602c8b907772021-10-10T11:29:57ZengNature Publishing GroupScientific Reports2045-23222021-10-0111111210.1038/s41598-021-99540-1Clinical phenotypes from fatal cases of acute respiratory distress syndrome caused by pneumoniaKazuya Ichikado0Kodai Kawamura1Takeshi Johkoh2Kiminori Fujimoto3Ayumi Shintani4Satoru Hashimoto5Yoshitomo Eguchi6Yuko Yasuda7Keisuke Anan8Naoki Shingu9Yoshihiko Sakata10Junpei Hisanaga11Tatsuya Nitawaki12Miwa Iio13Yuko Sekido14Kenta Nishiyama15Kazunori Nakamura16Moritaka Suga17Hidenori Ichiyasu18Takuro Sakagami19Division of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDepartment of Radiology, Kansai Rosai HospitalDepartment of Radiology, Kurume University School of Medicine and Center for Diagnostic Imaging, Kurume University HospitalDepartment of Medical Statistics, Osaka City University Graduate School of MedicineDepartment of Anesthesiology and Intensive Care Medicine, Kyoto Prefectural University of MedicineDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDepartment of Respiratory Medicine, Faculty of Life Sciences, Kumamoto UniversityDepartment of Respiratory Medicine, Faculty of Life Sciences, Kumamoto UniversityAbstract There have been no report of objective clinical characteristics or prognostic factors that predict fatal outcome of acute respiratory distress syndrome (ARDS) since the Berlin definition was published. The aim of this study is to identify clinically available predictors that distinguish between two phenotypes of fatal ARDS due to pneumonia. In total, 104 cases of Japanese patients with pneumonia-induced ARDS were extracted from our prospectively collected database. Fatal cases were divided into early (< 7 days after diagnosis) and late (≥ 7 days) death groups, and clinical variables and prognostic factors were statistically evaluated. Of the 50 patients who died within 180 days, 18 (36%) and 32 (64%) were in the early (median 2 days, IQR [1, 5]) and late (median 16 days, IQR [13, 29]) death groups, respectively. According to multivariate regression analyses, the APACHE II score (HR 1.25, 95%CI 1.12–1.39, p < 0.001) and the disseminated intravascular coagulation score (HR 1.54, 95%CI 1.15–2.04, p = 0.003) were independent prognostic factors for early death. In contrast, late death was associated with high-resolution computed tomography (HRCT) score indicating early fibroproliferation (HR 1.28, 95%CI 1.13–1.42, p < 0.001) as well as the disseminated intravascular coagulation score (HR 1.24, 95%CI 1.01–1.52, p = 0.039). The extent of fibroproliferation on HRCT, and the APACHE II scores along with coagulation abnormalities, should be considered for use in predictive enrichment and personalized medicine for patients with ARDS due to pneumonia.https://doi.org/10.1038/s41598-021-99540-1 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kazuya Ichikado Kodai Kawamura Takeshi Johkoh Kiminori Fujimoto Ayumi Shintani Satoru Hashimoto Yoshitomo Eguchi Yuko Yasuda Keisuke Anan Naoki Shingu Yoshihiko Sakata Junpei Hisanaga Tatsuya Nitawaki Miwa Iio Yuko Sekido Kenta Nishiyama Kazunori Nakamura Moritaka Suga Hidenori Ichiyasu Takuro Sakagami |
spellingShingle |
Kazuya Ichikado Kodai Kawamura Takeshi Johkoh Kiminori Fujimoto Ayumi Shintani Satoru Hashimoto Yoshitomo Eguchi Yuko Yasuda Keisuke Anan Naoki Shingu Yoshihiko Sakata Junpei Hisanaga Tatsuya Nitawaki Miwa Iio Yuko Sekido Kenta Nishiyama Kazunori Nakamura Moritaka Suga Hidenori Ichiyasu Takuro Sakagami Clinical phenotypes from fatal cases of acute respiratory distress syndrome caused by pneumonia Scientific Reports |
author_facet |
Kazuya Ichikado Kodai Kawamura Takeshi Johkoh Kiminori Fujimoto Ayumi Shintani Satoru Hashimoto Yoshitomo Eguchi Yuko Yasuda Keisuke Anan Naoki Shingu Yoshihiko Sakata Junpei Hisanaga Tatsuya Nitawaki Miwa Iio Yuko Sekido Kenta Nishiyama Kazunori Nakamura Moritaka Suga Hidenori Ichiyasu Takuro Sakagami |
author_sort |
Kazuya Ichikado |
title |
Clinical phenotypes from fatal cases of acute respiratory distress syndrome caused by pneumonia |
title_short |
Clinical phenotypes from fatal cases of acute respiratory distress syndrome caused by pneumonia |
title_full |
Clinical phenotypes from fatal cases of acute respiratory distress syndrome caused by pneumonia |
title_fullStr |
Clinical phenotypes from fatal cases of acute respiratory distress syndrome caused by pneumonia |
title_full_unstemmed |
Clinical phenotypes from fatal cases of acute respiratory distress syndrome caused by pneumonia |
title_sort |
clinical phenotypes from fatal cases of acute respiratory distress syndrome caused by pneumonia |
publisher |
Nature Publishing Group |
series |
Scientific Reports |
issn |
2045-2322 |
publishDate |
2021-10-01 |
description |
Abstract There have been no report of objective clinical characteristics or prognostic factors that predict fatal outcome of acute respiratory distress syndrome (ARDS) since the Berlin definition was published. The aim of this study is to identify clinically available predictors that distinguish between two phenotypes of fatal ARDS due to pneumonia. In total, 104 cases of Japanese patients with pneumonia-induced ARDS were extracted from our prospectively collected database. Fatal cases were divided into early (< 7 days after diagnosis) and late (≥ 7 days) death groups, and clinical variables and prognostic factors were statistically evaluated. Of the 50 patients who died within 180 days, 18 (36%) and 32 (64%) were in the early (median 2 days, IQR [1, 5]) and late (median 16 days, IQR [13, 29]) death groups, respectively. According to multivariate regression analyses, the APACHE II score (HR 1.25, 95%CI 1.12–1.39, p < 0.001) and the disseminated intravascular coagulation score (HR 1.54, 95%CI 1.15–2.04, p = 0.003) were independent prognostic factors for early death. In contrast, late death was associated with high-resolution computed tomography (HRCT) score indicating early fibroproliferation (HR 1.28, 95%CI 1.13–1.42, p < 0.001) as well as the disseminated intravascular coagulation score (HR 1.24, 95%CI 1.01–1.52, p = 0.039). The extent of fibroproliferation on HRCT, and the APACHE II scores along with coagulation abnormalities, should be considered for use in predictive enrichment and personalized medicine for patients with ARDS due to pneumonia. |
url |
https://doi.org/10.1038/s41598-021-99540-1 |
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