Data from: Clinical characteristics and prognosis of drug-associated acute respiratory distress syndrome compared with non-drug-associated acute respiratory distress syndrome: a single center retrospective study in Japan

Objectives: To report the clinical features and prognosis of drug-associated ARDS.
Design: A retrospective analysis of data collected during a prospective cohort study.
Setting: Intensive care unit in a teaching hospital.
Participants: A total of 197 Japanese ARDS patients diagnosed by the Berlin definition who were admitted to the Division of Respiratory Medicine from October 2004 to December 2015 were enrolled in the study, and were classified as two groups according to their causes: a drug-associated ARDS group (n=27) and a non-drug-associated ARDS group (n=170).
Primary outcome measure is 28-day mortality and the secondary is ventilator-free days.
Results: The Acute Physiology and Chronic Health Evaluation II scores were significantly lower in the drug-associated ARDS group than in the non-drug-associated ARDS group (median [IQR], 18.0 [16.5−21.0] vs 23.0 [18.0−26.0], p < 0.001), and the PaO2/FIO2 ratio was higher (148.0 [114.1−177.5] vs 101.0 [71.5−134.0], p = 0.003). In the drug-associated ARDS group, although high-resolution computed tomography scores indicative of the extent of fibroproliferation (301.6 [244.1−339.8] vs 208.3 [183.4−271.6], p < 0.001), serum lactate dehydrogenase levels (477 [365−585] vs 322 [246−434], p = 0.003), and the McCabe scores (score 1/2/3, n (%); 20 (74)/4 (15)/3 (11) vs 154 (91)/7 (4)/9 (5), p = 0.04) were significantly higher, ventilator weaning was earlier (p < 0.001), and 28-day mortality was better (p = 0.043). After adjusting for potentially confounding covariates, drug-associated ARDS group was associated with lower 28-day mortality (adjusted hazard ratio [HR], 0.275; 95 % confidence interval [CI], 0.106–0.711; P = 0.008).
Conclusions: Although more severe lung damage with fibroproliferation was observed in drug-associated ARDS patients, ventilator weaning was earlier, and their prognosis was better than the others. Further well-designed prospective studies are needed.