Mortality associated with acute respiratory distress syndrome, 2009-2019: a systematic review and meta-analysis

IF 1.4 4区医学 Q3 CRITICAL CARE MEDICINE

Critical Care and Resuscitation Pub Date : 2022-12-05 DOI:10.51893/2022.4.OA4

Divyajot Sadana , Simrat Kaur , Kesavan Sankaramangalam , Ishan Saini , Kinjal Banerjee , Matthew Siuba , Valentina Amaral , Shruti Gadre , Heather Torbic , Sudhir Krishnan , Abhijit Duggal

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引用次数: 0

Abstract

Background: Acute respiratory distress syndrome (ARDS) occurs commonly in intensive care units. The reported mortality rates in studies evaluating ARDS are highly variable.

Objective: To investigate mortality rates due to ARDS from before the 2009 H1N1 influenza pandemic began until the start of coronavirus disease 2019 (COVID-19) pandemic.

Design: We performed a systematic search and then ran a proportional meta-analysis for mortality. We ran our analysis in three ways: for randomised controlled trials only, for observational studies only, and for randomised controlled trials and observational studies combined.

Data sources: MEDLINE and Embase, using a highly sensitive criterion and limiting the search to studies published from January 2009 to December 2019.

Review methods: Two of us independently screened titles and abstracts to first identify studies and then complete full text reviews of selected studies. We assessed risk of bias using the Cochrane RoB-2 (a risk-of-bias tool for randomised trials) and the Cochrane ROBINS-1 (a risk-of-bias tool for non-randomised studies of interventions).

Results: We screened 5844 citations, of which 102 fully met our inclusion criteria. These included 34 randomised controlled trials and 68 observational studies, with a total of 24 158 patients. The weighted pooled mortality rate for all 102 studies published from 2009 to 2019 was 39.4% (95% CI, 37.0–41.8%). Mortality was higher in observational studies compared with randomised controlled trials (41.8% [95% CI, 38.9–44.8%] v 34.5% [95% CI, 30.6–38.5%]; P = 0.005).

Conclusions: Over the past decade, mortality rates due to ARDS were high. There is a clear distinction between mortality in observational studies and in randomised controlled trials. Future studies need to report mortality for different ARDS phenotypes and closely adhere to evidence-based medicine.

PROSPERO registration: CRD42020149712 (April 2020).

查看原文本刊更多论文

2009-2019年与急性呼吸窘迫综合征相关的死亡率:系统回顾和荟萃分析

背景:急性呼吸窘迫综合征(ARDS)常见于重症监护病房。在评估ARDS的研究中报告的死亡率变化很大。目的:调查2009年H1N1流感大流行开始前至2019年冠状病毒病(COVID-19)大流行开始期间ARDS的死亡率。设计:我们进行了系统搜索，然后对死亡率进行了比例荟萃分析。我们以三种方式进行了分析:仅针对随机对照试验，仅针对观察性研究，以及随机对照试验和观察性研究相结合。数据来源:MEDLINE和Embase，使用高度敏感的标准，并将搜索限制在2009年1月至2019年12月发表的研究。综述方法:我们两人独立筛选标题和摘要，首先确定研究，然后完成选定研究的全文综述。我们使用Cochrane rob2(随机试验的偏倚风险工具)和Cochrane ROBINS-1(非随机干预研究的偏倚风险工具)评估偏倚风险。结果:我们筛选了5844篇引文，其中102篇完全符合我们的纳入标准。其中包括34项随机对照试验和68项观察性研究，共有24158名患者。2009年至2019年发表的所有102项研究的加权合并死亡率为39.4% (95% CI, 37.0-41.8%)。观察性研究的死亡率高于随机对照试验(41.8% [95% CI, 38.9-44.8%] vs 34.5% [95% CI, 30.6-38.5%];P = 0.005)。结论:在过去的十年中，ARDS的死亡率很高。观察性研究和随机对照试验的死亡率有明显区别。未来的研究需要报告不同ARDS表型的死亡率，并密切遵循循证医学。普洛斯彼罗注册:CRD42020149712(2020年4月)。

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来源期刊

Critical Care and Resuscitation CRITICAL CARE MEDICINE-

CiteScore

7.70

自引率

3.40%

发文量

审稿时长

>12 weeks

期刊介绍： ritical Care and Resuscitation (CC&R) is the official scientific journal of the College of Intensive Care Medicine (CICM). The Journal is a quarterly publication (ISSN 1441-2772) with original articles of scientific and clinical interest in the specialities of Critical Care, Intensive Care, Anaesthesia, Emergency Medicine and related disciplines. The Journal is received by all Fellows and trainees, along with an increasing number of subscribers from around the world. The CC&R Journal currently has an impact factor of 3.3, placing it in 8th position in world critical care journals and in first position in the world outside the USA and Europe.