Prognostic Factors Of Young And Elderly Patients With Moderate And Severe Acute Respiratory Distress Syndrome

Objective:To analyzing the predisposing factors,clinical characteristics and risk factors of prognosis between young and elder patients with moderate and severe acute respiratory distress syndrome.Methods:Retrospective analysis between January 2013 and July 2016,The Second Affiliated Hospital of Chongqing Medical University,moderate and severe ARDS in RICU and ICU in accord with the Berlin definition of the clinical data of 145 patients.The patients over 65 years old were served as elderly group,and those younger than 65 years old were served as young group,and the patients were subdivided into non-survivors and survivors groups.Record after admission in patients with clinical characteristics of the relevant indicators,univariate Logistical regression analysis of clinical characteristics of young and elderly group;Prognosis of univariate Logistical regression analysis of different groups,and the statistical significant variables were analyzed by multivariate logistical regression analysis.Results :1.Severe pneumonia was most common in young and elderly of moderate and severe ARDS patients of the predisposing factors,59.70% and 60.26%,respectively,followed by septic shock,respectively 17.91% and 15.38%,the constituent ratios of the predisposing more similar between the two groups has no statistical significance(P > 0.05).2.Compared with the young group,ICU length of days(9.79±6.50 VS 12.85±7.81,d),mechanical ventilation days(8.34±5.81 VS 11.16±7.04,d),the number of organ dysfunction[2.00(1.00,3.00)VS 3.00(2.00,4.00)],APECHE ? score(15.01±6.51 VS 20.26±5.71),SOFA score(7.49±4.14 VS 10.82±4.13),mortality of elderly group(59.70% VS 76.92%)were significantly increased,however,the levels of albumin was significantly decreased(28.36±4.74 VS 26.74±4.85,g/l,P<0.05).3.Univariate logistical regression analysis showed that the hospital length of stays,the number of organ dysfunction,blood lactate,APECHE ? score and SOFA score were closely connected with the prognosis of moderate and severe ARDS(all P < 0.05),by multivariate logistical regression analysis,APECHE ? score(OR: 5.888,95%CI: 1.184 to 29.290,P=0.030)and the number of organ dysfunction(OR: 0.060,95%CI: 0.005 to 0.949,P=0.046)were independent risk factors of the prognosis of the elderly of moderate and severe ARDS.4.Univariate logistical regression analysis showed that the hospital length of stays,ICU length of days,the number of organ dysfunction,PCT,blood lactate,APECHE ? score and SOFA score were closely connected with the prognosis of moderate and severe ARDS(all P < 0.05),by multivariate logistical regression analysis,APECHE ? score(OR: 1.363,95%CI: 1.046 to 1.778,P=0.022)and SOFA score(OR: 3.672,95%CI: 1.069 to 12.610,P=0.039)were independent risk factors of the prognosis of the young of moderate and severe ARDS.Conclusion :1.Compared with the young group,ICU length of days,mechanical ventilation days,the number of organ dysfunction,APECHE ? score,SOFA score,mortality of elderly group were increased,however,the levels of albumin was decreased.2.Higher APECHE?score and SOFA score were the high risk factors in the young of moderate and severe ARDS,Higher APECHE?score and the number of organ dysfunction were the high risk factors in the elderly of moderate and severe ARDS.