Respiratory failure & ventilation
Secular Trends in ARDS: A 20-Year Analysis of the National Inpatient Sample
Authors' conclusion
This 20-year analysis reveals diverging trends in ARDS outcomes across coding eras. Improvements in mortality during the ICD-9-CM era were not sustained in the ICD-10-CM period.
Study context
- Population
- Adult, nonelective US admissions with ARDS and concurrent invasive mechanical ventilation, 2000–2019
- Participants
- 205,393 admissions
- Exposure
- Trends over time within ICD-9-CM era and ICD-10-CM era
- ICD-9-CMn = 146,888
- ICD-10-CMn = 58,505
- Outcome
- In-hospital mortality (trend over time)
Methodological detailsNational Inpatient Sample, adjusted trend analyses, stratified by ICD coding era
- National Inpatient Sample
- Adjusted trend analyses
- Stratified by ICD coding era
Main finding
As reported in the abstract
In-hospital mortality trend per year
Odds ratio per year (95% CI)P value
ICD-9-CMmortality declined
0.96(0.95–0.97)
P < 0.001ICD-10-CMmortality increased
1.05(1.01–1.08)
P = 0.004Per year, as printed
Observational data: associations, not effects.
Further findings
LOS and hospitalization charges (2019 dollars)
- Decreased during the ICD-9-CM era; no significant improvement in the ICD-10-CM period
Case-mix
- ICD-10-CM cohort had greater comorbidity burden and more often pulmonary etiology of ARDS
Original publication
Secular Trends in ARDS: A 20-Year Analysis of the National Inpatient Sample. Chest. Published 26 March 2026. doi:10.
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