About: Prognostic factors for ARDS: clinical, physiological and atypical immunodeficiency

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An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Prognostic factors for ARDS: clinical, physiological and atypical immunodeficiency
Creator	Chen, Ping Luo, Hong Peng, Hong Song, Min Liu, Yijie Lu, Zhiwen
Source	PMC
abstract	BACKGROUND: Risk factors affecting the prognosis of acute respiratory distress syndrome (ARDS) in adults were investigated. The aim was to identify new predictors for ARDS patient prognosis, including those with clinical, pathophysiological, and atypical immunodeficiency. METHODS: ARDS patients were retrospectively included. The patients were grouped and analysed according to different oxygenation index grades and prognosis, and factors influencing prognosis and survival were examined. Adolescent patients, patients with typical immunodeficiency and patients who died within 24 h after being diagnosed with ARDS were excluded. The predictive value for mortality was determined by Cox proportional hazard analysis. RESULTS: In total, 201 patients who fulfilled the Berlin definition of ARDS were included. The severity of critical illness on the day of enrolment, as measured by the Acute Physiology and Chronic Health Evaluation (APACHE) II score (P = 0.016), Sequential Organ Failure Assessment (SOFA) score (P = 0.027), and PaO(2)/FiO(2) (P = 0.000), worsened from mild to severe ARDS cases. Compared with survivors, non-survivors were significantly older and had higher APACHE II and SOFA scores. Moreover, significantly lower lymphocyte/neutrophil ratios and leukocyte counts were found among non-survivors than survivors (P = 0.008, P = 0.012). A moderate positive correlation between the lymphocyte/neutrophil and PaO(2)/FiO(2) ratios (P = 0.023) was observed. In predicting 100-day survival in patients with ARDS, the area under the curve (AUC) for the lymphocyte/neutrophil ratio was significantly higher than those for the PaO(2)/FiO(2) ratio alone, body mass index (BMI) alone, and the lymphocyte count alone (P = 0.0062, 0.0001, and 0.0154). Age (per log(10) years), BMI < 24, SOFA score, leukocyte count, and the lymphocyte/neutrophil ratio were independent predictors of 28-day mortality in ARDS patients. Additionally, ARDS patients with a lymphocyte/neutrophil ratio < 0.0537 had increased 28-day mortality rates (P = 0.0283). Old age affected both 28-day and 100-day mortality rates (P = 0.0064,0.0057). CONCLUSIONS: Age (per log(10) years), BMI < 24, SOFA score, lymphocytes, and the lymphocyte/neutrophil ratio were independent predictors of 100-day mortality in patients with ARDS. The lymphocyte/neutrophil ratio may represent a potential molecular marker to evaluate atypical immunosuppression or impairment in patients with ARDS.
has issue date	2020-04-23(xsd:dateTime)
bibo:doi	10.1186/s12890-020-1131-0
bibo:pmid	32326923
has license	cc-by
sha1sum (hex)	a0d763ec922163714b323b9fd359ff8910c2ef11
schema:url	https://doi.org/10.1186/s12890-020-1131-0
resource representing a document's title	Prognostic factors for ARDS: clinical, physiological and atypical immunodeficiency
has PubMed Central identifier	PMC7179796
has PubMed identifier	32326923
schema:publication	BMC Pulm Med
resource representing a document's body	covid:a0d763ec922163714b323b9fd359ff8910c2ef11#body_text
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