Respiratory failure & ventilation
Outcomes and time trends of acute respiratory distress syndrome patients with and without liver cirrhosis: an observational cohort
Main finding · 90 day mortalityResult — go to the resultHazard ratio 1.56 95% CI 1.20–2.02Authors' conclusion
Although ARDS management improved over the last decades, the 90 day mortality remained high and stable over time for both ARDS patients with (57%) and without cirrhosis (41%). Nevertheless, the severity of patients without cirrhosis has increased over time, while the severity of patients with cirrhosis has remained stable.
Study context
- Population
- Consecutive adult critically ill patients with acute respiratory distress syndrome (ARDS) (Berlin criteria), 20-bed tertiary ICU, October 2003 to December 20217,155 screened
- Participants
- 863 patients
- Exposure
- ARDS with vs without liver cirrhosis
- Cirrhosisn = 157
- No cirrhosisn = 706reference
- Outcome
- Mortality (Kaplan-Meier curves and multivariate Cox analysis)
- Follow-up
- 90 day
Methodological detailssingle-centre, tertiary ICU, consecutive patients
- Single-centre
- Tertiary ICU
- Consecutive patients
Main finding
90 day mortality
Hazard ratio
1.56
95% CI 1.20–2.02
Events by group
Cirrhosis vs No cirrhosis
HR 1.56 (95% CI 1.20–2.02)
As reported in the abstract
- Overall 90 day mortality
- 43% (378/863)
Observational data: associations, not effects.
Further findings
Time trend in 90 day mortality
- No change in mortality over time in ARDS patients with and without cirrhosis
Time trend in SOFA and non-hepatic SOFA
- SOFA increased over time without cirrhosis
- P = 0.04
- Non-hepatic SOFA increased over time without cirrhosis
- P = 0.02
- SOFA and non-hepatic SOFA stable over time with cirrhosis
Ventilation settings (tidal volume, PEEP, plateau pressure, driving pressure)
- Not different between ARDS patients with and without cirrhosis
Original publication
Outcomes and time trends of acute respiratory distress syndrome patients with and without liver cirrhosis: an observational cohort. Ann Intensive Care. Published 29 September 2023. doi:10.
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