Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy.

Diffuse alveolar damage (DAD) is a typical pathological finding of open lung biopsies in patients with acute respiratory distress syndrome (ARDS). Patients with ARDS and DAD have been reported to have a poorer prognosis than those without DAD. The aim of this study was to investigate the survival pr...

Full description

Bibliographic Details
Main Authors: Kuo-Chin Kao, Chih-Hao Chang, Chen-Yiu Hung, Li-Chung Chiu, Chung-Chi Huang, Han-Chung Hu
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC5497963?pdf=render
id doaj-7fee51f9336b486cb57393463226f767
record_format Article
spelling doaj-7fee51f9336b486cb57393463226f7672020-11-24T21:49:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01127e018001810.1371/journal.pone.0180018Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy.Kuo-Chin KaoChih-Hao ChangChen-Yiu HungLi-Chung ChiuChung-Chi HuangHan-Chung HuDiffuse alveolar damage (DAD) is a typical pathological finding of open lung biopsies in patients with acute respiratory distress syndrome (ARDS). Patients with ARDS and DAD have been reported to have a poorer prognosis than those without DAD. The aim of this study was to investigate the survival predictors in patients with ARDS and DAD.We retrospectively reviewed all ARDS patients who underwent an open lung biopsy which showed evidence of DAD from January 2006 to June 2015 at Chang Gung Memorial Hospital. Clinical data including baseline characteristics, medication, and survival outcomes were analyzed.A total of 64 ARDS patients with DAD were eligible for analysis and divided into known etiology (n = 17, 26.6%) and unknown etiology groups (n = 47, 73.4%). There was no significant difference in hospital mortality rate between the two groups (71.9% vs. 70.6%, p = 0.890). Univariate logistic regression analysis revealed that sequential organ failure assessment (SOFA) score at the time of a diagnosis of ARDS, and SOFA score, PaO2/FiO2 ratio, and positive end expiratory pressure level when the biopsy was performed were associated with hospital mortality. Multivariate analysis showed that the SOFA score on the day of the biopsy was an independent predictor of hospital mortality (odds ratio 1.413, 95% confidence interval 1.127-1.772; p = 0.03). There were no significant differences in the use, dose, duration and timing from ARDS to glucocorticoid therapy between the survivors and nonsurvivors.For selected ARDS patients who underwent an open lung biopsy with pathological DAD, SOFA score was an independent predictor of hospital mortality.http://europepmc.org/articles/PMC5497963?pdf=render
collection DOAJ
language English
format Article
sources DOAJ
author Kuo-Chin Kao
Chih-Hao Chang
Chen-Yiu Hung
Li-Chung Chiu
Chung-Chi Huang
Han-Chung Hu
spellingShingle Kuo-Chin Kao
Chih-Hao Chang
Chen-Yiu Hung
Li-Chung Chiu
Chung-Chi Huang
Han-Chung Hu
Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy.
PLoS ONE
author_facet Kuo-Chin Kao
Chih-Hao Chang
Chen-Yiu Hung
Li-Chung Chiu
Chung-Chi Huang
Han-Chung Hu
author_sort Kuo-Chin Kao
title Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy.
title_short Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy.
title_full Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy.
title_fullStr Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy.
title_full_unstemmed Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy.
title_sort survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2017-01-01
description Diffuse alveolar damage (DAD) is a typical pathological finding of open lung biopsies in patients with acute respiratory distress syndrome (ARDS). Patients with ARDS and DAD have been reported to have a poorer prognosis than those without DAD. The aim of this study was to investigate the survival predictors in patients with ARDS and DAD.We retrospectively reviewed all ARDS patients who underwent an open lung biopsy which showed evidence of DAD from January 2006 to June 2015 at Chang Gung Memorial Hospital. Clinical data including baseline characteristics, medication, and survival outcomes were analyzed.A total of 64 ARDS patients with DAD were eligible for analysis and divided into known etiology (n = 17, 26.6%) and unknown etiology groups (n = 47, 73.4%). There was no significant difference in hospital mortality rate between the two groups (71.9% vs. 70.6%, p = 0.890). Univariate logistic regression analysis revealed that sequential organ failure assessment (SOFA) score at the time of a diagnosis of ARDS, and SOFA score, PaO2/FiO2 ratio, and positive end expiratory pressure level when the biopsy was performed were associated with hospital mortality. Multivariate analysis showed that the SOFA score on the day of the biopsy was an independent predictor of hospital mortality (odds ratio 1.413, 95% confidence interval 1.127-1.772; p = 0.03). There were no significant differences in the use, dose, duration and timing from ARDS to glucocorticoid therapy between the survivors and nonsurvivors.For selected ARDS patients who underwent an open lung biopsy with pathological DAD, SOFA score was an independent predictor of hospital mortality.
url http://europepmc.org/articles/PMC5497963?pdf=render
work_keys_str_mv AT kuochinkao survivalpredictorinpatientswithacuterespiratorydistresssyndromeanddiffusealveolardamageundergoingopenlungbiopsy
AT chihhaochang survivalpredictorinpatientswithacuterespiratorydistresssyndromeanddiffusealveolardamageundergoingopenlungbiopsy
AT chenyiuhung survivalpredictorinpatientswithacuterespiratorydistresssyndromeanddiffusealveolardamageundergoingopenlungbiopsy
AT lichungchiu survivalpredictorinpatientswithacuterespiratorydistresssyndromeanddiffusealveolardamageundergoingopenlungbiopsy
AT chungchihuang survivalpredictorinpatientswithacuterespiratorydistresssyndromeanddiffusealveolardamageundergoingopenlungbiopsy
AT hanchunghu survivalpredictorinpatientswithacuterespiratorydistresssyndromeanddiffusealveolardamageundergoingopenlungbiopsy
_version_ 1725888849002889216