Risk Factors In Developing Acute Respiratory Distress Syndrome In Septic Patients

Objectives: Sepsis is a major cause of Acute Respiratory Distress Syndrome(ARDS)in intensive care unit(ICU),but with the changing of definition of such clinical syndrome,no studies have been conducted on the risk factors for ARDS in patients with sepsis under the new diagnostic criteria.The aim of this study was to analyze the risk factors for patients with sepsis and ARDS,and to guide the early intervention of patients with high risk factors,reduce the incidence of ARDS,and improve the prognosis of such patients.Methods: 529 septic patients were enrolled in the ICU of the First Affiliated Hospital of China Medical University from January 2017 to September 2018.Statistical Product and Service Solutions(SPSS)17.0 were used for statistical analysis,and P value < 0.05 was considered statistically significant.Variables with significant differences in the univariate analysis were gradually included in the multivariate analysis to determine the independent risk factors for sepsis combined with ARDS.Results: Mechanical ventilation time(114 hs vs.34.2 hs)and ICU inward time(7 ds vs.4 ds)were longer in patients who developed ARDS than those without ARDS(Both P<0.05);ICU fatality rate(23% vs.10%)and 28-day fatality rate(47% vs.24%)were higher than those without ARDS(Both P<0.05).There were differences in gender,age,and whether the patients had malignant tumors and whether they had received transfusion therapy(P<0.05).The site of infection in septic patients was associated with developing ARDS,including pneumonia [OR: 1.880,95% CI(1.235-2.861)] and pancreatitis with peri-pancreatic infection [OR: 3.719,95% CI(1.609-8.595)](P<0.05).Septic shock patients,patients with higher Sequential Organ Failure Assessment score(SOFA)and non-pulmonary SOFA score are likely to develop ARDS.Conclusions: There were risk factors in developing ARDS in septic patients.Pneumonia,pancreatitis with peri-pancreatic infection,septic shock,SOFA score,and non-pulmonary SOFA score are independent risk factors for sepsis in developing ARDS.