Incidence of and Risk Factors for Acute Respiratory Distress Syndrome in Patients Admitted to Surgical Intensive Care Units: The Multicenter Thai University- Based Surgical Intensive Care Unit (THAI-SICU) Study
Onuma Chaiwat MD*1, Kaweesak Chittawatanarat MD, PhD*2, Annop Piriyapathsom MD*1, Chawika Pisitsak MD*3, Thammasak Thawitsri MD*4, Sunisa Chatmongkolchart MD*5, Suneerat Kongsayreepong MD*1, the THAI-SICU study group
Affiliation : *1 Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand *2 Department of Surgery, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand *3 Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand *4 Department of Anesthesiology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand *5 Department of Anesthesiology, Faculty of Medicine, Prince of Songkhla University, Songkhla, Thailand
Objective : The incidence and outcomes of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) are unclear.
We evaluated the cumulative incidence of, risk factors for, and outcomes of ALI/ARDS in surgical ICUs (SICUs).
Material and Method: The multicenter Thai University-based Surgical Intensive Care Unit (THAI-SICU) study was a
prospective, observational cohort study including nine university-based SICUs throughout Thailand from April 2011 to
January 2013. All >18-year-old surgical patients who were admitted to general SICUs were recruited. The primary outcome
was the incidence of ALI/ARDS.
Results : In total, 4,652 patients were analyzed. ALI/ARDS new developed in 114 patients (2.5%). Patients with ALI/ARDS had
higher APACHE II (20.0 vs. 11.4, respectively; p<0.001) and SOFA scores (7.3 vs. 3.1, respectively; p<0.001) and a higher
incidence of past or current smoking (48% vs. 36%, respectively; p<0.001) than the non-ARDS patients. The 28-day
mortality rate was significantly higher in patients with than without ALI/ARDS (50% vs. 12%; p<0.001). Higher APACHE II
and SOFA scores and higher rates of current or past smoking were independent predictors of ALI/ARDS.
Conclusion : The incidence of ALI/ARDS in the THAI-SICU study was low, but the mortality rate was high. Higher severity
scores and smoking were associated with ALI/ARDS.
Keywords : Acute lung injury, Acute respiratory distress syndrome, Incidence, Critically ill, Surgical
