Respiratory failure & ventilation
Morphological subphenotypes of acute pancreatitis-related acute respiratory distress syndrome
Main finding · 90-day mortalityResult — go to the resultAdjusted hazard ratio 1.01 CI 0.58–1.76Authors' conclusion
Two morphological subphenotypes of Acute Pancreatitis-related ARDS were identified and were evenly distributed. Although their clinical characteristics and outcomes were comparable, they exhibited treatment-specific responses: prone positioning was associated with lower mortality in Focal ARDS, whereas high PEEP was associated with lower mortality in Non-Focal ARDS.
Study context
- Population
- Critically ill adults with acute pancreatitis-related Acute Respiratory Distress Syndrome (ARDS) and early CT-scan admitted to ICU, 2003–20235,865 screened
- Participants
- 151 adults
- Exposure
- Focal ARDS vs Non-Focal ARDS
- Focal ARDSn = 81
- Non-Focal ARDSn = 70reference
- Outcome
- 90-day mortality
- Follow-up
- 90 days
Methodological detailsconsecutive patients, multivariate Cox analysis, machine-learning models (XGBoost, SHAP)
- Consecutive patients
- Multivariate Cox analysis
- Machine-learning models (XGBoost, SHAP)
Main finding
As reported in the abstract
Adjusted hazard ratio
1.01
CI 0.58–1.76
P = 0.98
Events by group
Observational data: associations, not effects.
Further findings
Prone position and 90-day mortality (Focal ARDS subgroup)
| aHR (CI) | P value | ||
|---|---|---|---|
| Prone positionNot associated in Non-Focal ARDS | 0.25 (0.08–0.76) | P = 0.015 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
High PEEP and 90-day mortality (Non-Focal ARDS subgroup)
| aHR (CI) | P value | ||
|---|---|---|---|
| High PEEPNot associated in Focal ARDS | 0.22 (0.06–0.85) | P = 0.029 | |
| 0.050.21520Adjusted hazard ratio (log scale) |
Overall 90-day mortality
- Overall 90-day mortality (56/151)
- 37%
ARDS management
- No significant difference in ARDS management
Original publication
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