Clinical epidemiology and mortality on patients with acute respiratory distress syndrome (ARDS) in Vietnam

• Published in: PloS one Vol. 14; no. 8; p. e0221114
• Main Authors: Chinh, Luong Quoc, Manabe, Toshie, Son, Do Ngoc, Chi, Nguyen Van, Fujikura, Yuji, Binh, Nguyen Gia, Co, Dao Xuan, Tuan, Dang Quoc, Ton, Mai Duy, Dai, Khuong Quoc, Thach, Pham The, Nagase, Hiroyuki, Kudo, Koichiro, Nguyen, Dat Anh
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 15.08.2019; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Adult respiratory distress syndrome; Avian flu; Biology and Life Sciences; Clinical medicine; Confidence intervals; Critical care; Disease-Free Survival; Engineering and Technology; Epidemiology; Female; Gas exchange; Health care policy; Hospitals; Humans; Intensive care; Laboratories; Male; Medical prognosis; Medical research; Medicine; Medicine and Health Sciences; Middle Aged; Mortality; Observational studies; Patient outcomes; Patients; People and Places; Physical Sciences; Pneumonia; Prognosis; Regression analysis; Respiratory distress syndrome; Respiratory Distress Syndrome, Adult - diagnosis; Respiratory Distress Syndrome, Adult - mortality; Respiratory Distress Syndrome, Adult - therapy; Respiratory therapy; Retrospective Studies; Risk analysis; Risk Factors; Statistical analysis; Statistics; Survival; Survival Rate; Ventilators; Vietnam - epidemiology; Vietnam; Mexico; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0221114

The clinical epidemiology and disease prognosis in patients with acute respiratory distress syndrome (ARDS) have not yet been fully elucidated in Vietnam. We conducted a retrospective observational study at a national tertiary hospital in Hanoi, Vietnam. Participants were adult patients (age ≥18 years) who were admitted and diagnosed with ARDS during 2015-2017. Data on patients' general and clinical conditions, radiographic findings, ventilator settings, gas exchange, and treatment methods were collected and compared between survivors and non-survivors. Risk factors for mortality were assessed using logistic regression analysis. Among 126 eligible patients with ARDS admitted to the central tertiary hospital in Vietnam, we observed high mortality (57.1%). Of the total patients, 91.3% were transferred from local hospitals with a diagnosis of severe pneumonia and then diagnosed with ARDS at the central hospital. At the time of admission, 53.2% of patients had severe ARDS, 37.3% had moderate ARDS, and 9.5% had mild ARDS. The mean (standard deviation) sequential organ failure assessment (SOFA) score was 9.5 (3.4) in non-survivors and 7.4 (3.4) in survivors (p = 0.002). Although there was no significant difference in PaO2/FiO2 on admission between non-survivors and survivors, that on day 3 after admission was significantly different (p = 0.002). Logistic regression revealed that PaO2/FiO2 on day 3 [odds ratio (OR), 1.010; 95% confidence interval (CI), 1.003-1.017], length of stay in a local hospital before admission to the central hospital (OR, 1.122; 95% CI, 1.042-1.210) due to stable condition, and SOFA score on Day 1 (OR, 0.842; 95% CI, 0.708-1.002) were independent factors in patient survival. Patients with ARDS admitted the central tertiary hospital had severe illness and high mortality. Most patients were transferred from local hospitals. Improvements in human, medical, and sociological resources in local will contribute to reducing the mortality of ARDS in Vietnam.