Retrospective Study Of 89 Patients With Acute Respiratory Distress Syndrome

Objective Retrospectively studied the clinical data of patients with ARDS in intensive medicine in Xinjiang Uygur autonomous region people's hospital,study our intensive medicine in patients with acute respiratory distress syndrome pathogenesis inducement,survival rate and mortality,and LIPS score,APACHE ? grading clinical indicators related to its relationship with prognosis.Method Patients with ARDS from January 2017 to January 2019 in our hospital were enrolled,collect patients basic information and related history,records include patients' age,gender,nationality,height,weight,medical history,history of diabetes,hypertension history,history of heart disease,cancer,kidney disease,rheumatism,immune disease history,family history,history of respiratory diseases,etc.),imaging data,28 days and clinical outcome.Peripheral venous and arterial blood was collected,and the blood routine,blood gas analysis,procalcitonin(PCT),lactic acid,c-reactive protein(CRP),biochemical routine,PH,ions and other results were collected.The Mann-Whitney U test to compare the survival group and death group,using Logistic regression analysis influences the outcome of risk factors for ARDS patients,analysis of ROC curve drawing LIPS,APACHE?,CRP/ALB,RDW/ALB in the diagnosis of ARDS prognostic value.Result 1.A total of 89 patients were provided for analysis,of which 51 survived and38 died.There were 67 males and 22 females.39 cases of ethnic minorities.The overall mean age was 54.8 years,the median age was 55.0 years(45.0?66.5),the minimum agewas 19 years,and the maximum age was 88 years.There were 25 cases of mild ARDS,26 cases of moderate ARDS and 38 cases of severe ARDS.2.Among the patients contained in the present study,21 were not complicated with chronic underlying diseases at the time of onset,while the remaining 68 were all complicated with chronic underlying diseases.There were 62 cases(69.7%)of direct lung injury and 27 cases(30.3%)of the indirect lung injury.Pneumonia and non-pulmonary sepsis were the primary causes.Among the etiological results,17 cases were positive in blood culture and 39 cases were positive in sputum culture.The detection rate of klebsiella pneumoniae in blood culture was higher,and that of acinetobacter baumannii in sputum culture was higher.3.The APACHE ?,LIPS,albumin,CRP/ALB,RDW,RDW/ALB,lactic acid comparing differences in survival group and death group was statistically significant(P< 0.05);Logistic regression analysis showed that RDW% and lactic acid were risk factors for death in ARDS patients,and ALB was protective factors for ARDS patients.4.APACHE ?,LIPS,RDW/ALB to the prognosis of no statistically significant difference(P > 0.05),and accuracy are better than CRP/ALB(P <0.05).APACHE ?joint LIPS for evaluation of prognosis of ARDS ROC curve with APACHE ? ROC curve statistical differences(P = 0.0318).Conclusion 1.Mortality rate of patients with mild ARDS in this study was 28.0%,moderate ARDS was 46.2%,severe ARDS patients were 50.0%.2.APACHE II score,LIPS score,lactic acid,albumin,RDW,CRP/ALB,RDW/ALB levels may be associated with prognosis in ARDS patients.3.The pathogenological examination of ARDS patients showed that the detection rate of klebsiella pneumoniae in blood culture was higher,and that of acinetobacter baumannii in sputum culture was higher.4.Kidneys were the most common extra pulmonary organs in ARDS patients,followedby circulatory system.5.The combination of APACHE II and LIPS score can improve the accuracy of prognosis evaluation.