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

Objectives To report the clinical features and prognosis of
drug-associatedacute respiratory distress syndrome (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 patients with ARDS 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 secondaryoutcome measure 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 arterial oxygen
tension/fractional inspired oxygen 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 CT 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)vs154 (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 HR (HR) 0.275; 95% CI 0.106 to 0.711; p=0.008). Conclusions
Although more severe lung damage with fibroproliferation was observed in
patients with drug-associated ARDS, ventilator weaning was earlier, and
their prognosis was better than the others. Further well-designed
prospective studies are needed.