Table 2.
Study characteristics for ARDS mortality
| Study | Study design | Setting | ARDS definition | Outcome | Total (n) | Non-survivors (n) | Age | Gender, male n (%) | Variables in multivariate analysis | Sample moment |
|---|---|---|---|---|---|---|---|---|---|---|
| Adamzik 2013 [58] | Prospective cohort | Single centre | AECC | 30 days | 47 | 17 | 44 ± 13 | 32 (68. 1%) | SAPS II score, gender, lung injury score, ECMO, CVVHD, BMI, CRP, procalcitonin | Within 24 h following ICU admission |
| Ahasic 2012 [24] | Prospective cohort | Multicentre | AECC | 60 days | 175 | 78 | 60.7 ± 17.6 | 102 (58.3%) | Gender, BMI, cirrhosis, Diabetes, need for red cell transfusion, sepsis, septic shock, trauma | Within 48 h following ICU admission |
| Amat 2000 [26] | Prospective cohort | Two centre | AECC ARDS | 1 month after ICU discharge | 21 | 11 | 54 ± 16 | 15 (71.4%) | Not specified | Day 0 ICU |
| Bajwa 2008 [59] | Prospective cohort | Single centre | AECC | 60 day | 177 | 70 | 68.3 ± 15.3 | 99 (55.9%) | APACHE III score | Within 48 h following ARDS onset |
| Bajwa 2009 [60] | Prospective cohort | Single centre | AECC | 60 days | 177 | 70 | 62.5 (IQR 29.0) | 100 (56.5%) | APACHE III score | Within 48 h following ARDS onset |
| Bajwa 2013 [61] | RCT (FACTT) | Multicentre | AECC | 60 days | 826 | NR | 48 (38–59 IQR) | 442 (53.5%) | APACHE III score | Days 0 and 3 |
| Calfee 2008 [62] | RCT (ARMA) | Multicentre | AECC | 180 days | 676 | NR | 51 ± 17 | 282 (41.7%) | Age, gender, APACHE III score, sepsis, or trauma | Day 0 |
| Calfee 2009 [63] | RCT (ARMA) | Multicentre | AECC | Hospital | 778 | 272 | 51 ± 17 | 459 (59.0%) | Age, PaO2/FiO2, APACHE III score, sepsis or trauma | Day 0 |
| Calfee 2011 [64] | RCT (ARMA) | Multicentre | AECC | 90 days | 547 | 186 | 50 ± 16 | 227 (41.5%) | APACHE III score, tidal volume | Day 0 |
| Calfee 2012 [65] | RCT (FACTT) | Multicentre | AECC | 90 days | 931 | 261 | 50 ± 16 | 498 (53.5%) | Age, APACHE III score, fluid management strategy | Day 0 |
| Calfee 2015 [66] | Prospective cohort | Single centre | AECC | Hospital | 100 | 31 | 58 ± 11 | 52 (52.0%) | APACHE III score | Day 2 following ICU admission |
| Calfee 2015 [66] | RCT (FACTT) | Multicentre | AECC | 90 days | 853 | 259 | 51 ± 15 | 444 (52.1%) | APACHE III score | Within 48 h following ARDS onset |
| Cartin-Ceba 2015 [67] | Prospective cohort | Single centre | AECC | In-hospital | 100 | 36 | 62.5 (51–75 IQR) | 54 (54.0%) | Acute physiology score of APACHE III score, DNR status, McCabe score | Within 24 h following diagnosis |
| Chen 2009 [68] | Prospective cohort | Single centre | * | 28 days | 59 | 26 | 62 ± 19 | 35 (59.3%) | APACHE II score, biomarkers | Within 24 h following diagnosis |
| Clark 1995 [69] | Prospective cohort | Single centre | ** | Mortality | 117 | 48 | 43.4 ± 15.4 | 75 (64.1%) | Lung injury score, risk factor for ARDS, lavage protein concentration | Day 3 following disease onset |
| Clark 2013 [70] | RCT (FACTT) | Multicentre | AECC | 60 days | 400 | 106 | 47 (37–57 IQR) | 210 (52.5%) | Age, gender, ethnicity, baseline serum creatinine, ARDS risk factor | Day 1 following inclusion |
| Dolinay 2012 [71] | Prospective cohort | Single centre | AECC | In-hospital | 28 | 17 | 54 ± 14.5 | 13 (46.4%) | APACHE II score | Within 48 h following ICU admission |
| Eisner 2003 [72] | RCT (ARMA) | Multicentre | AECC | 180 days | 565 | 195 | 51 ± 17 | 332 (58.8%) | Ventilation strategy, APACHE III score, PaO2/FiO2, creatinine, platelet count | Day 0 following inclusion |
| Forel 2015 [73] | Prospective cohort | Multicentrer | Berlin < 200 mmHg | ICU | 51 | NR (for ICU) | 60 ± 13 | 40 (78.4%) | Lung injury score | Day 3 |
| Forel 2018 [74] | Prospective cohort | Single centre | Berlin < 200 mmHg | 60 days | 62 | 21 | 59 ± 15 | 47 (75.8%) | Gender, SOFA score, LIS score | Day 3 following onset of ARDS |
| Guervilly 2011 [75] | Prospective cohort | Single centre | AECC | 28 days | 52 | 21 | 58 ± 17 | 39 (75.0%) | Not specified | Within 24 h following diagnosis |
| Kim 2019 [76] | Retrospective cohort | Single centre | Berlin | In-hospital | 97 | 63 | 67.2 (64.3–70.1) | 63 (64.3%) | APACHE II score, SOFA score, SAPS II score | Within 48 h following admission |
| Lee 2019 [77] | Retrospective cohort | Single centre | Berlin | In-hospital | 237 | 154 | 69 (61–74 IQR) | 166 (70.0%) | Age, diabetes mellitus, non-pulmonary source, APACHE II score, SOFA | Within 24 h following intubation |
| Lesur 2006 [78] | Prospective cohort | Multicentre | AECC | 28 days | 78 | 29 | 63 ± 16 | 48 (61.5%) | Age, PaCO2, APACHE II score | Within 48 h following onset of ARDS |
| Li 2019 [79] | Retrospective cohort | Single centre | Berlin | 28 days | 224 | 70 | 64 (46–77 IQR) | 140 (62.5%) | APACHE II score, age, gender, BMI, smoking status, alcohol abusing status, risk factors, comorbidities | Within 24 h following ICU admission |
| Lin 2010 [80] | Prospective cohort | Single centre | AECC ARDS | 28 days | 63 | 27 | 75 (57–83 IQR) | 38 (60.3%) | Age, lung injury score, SOFA score, APACHE II score, CRP, biomarkers | Within 24 h following ARDS onset |
| Lin 2012 [81] | Prospective cohort | Single centre | AECC | 30 days | 87 | 27 | 61 (56–70 IQR) | 42 (48.3%) | APACHE II, Lung injury score, creatinine, biomarkers | At inclusion |
| Lin 2013 [82] | Prospective cohort | Single centre | AECC | 30 days | 78 | 22 | 63 (54–68 IQR) | 45 (57.7%) | Age, APACHE II score, Lung injury score, PaO2/FiO2 | Within 10 h following diagnosis |
| Madtes 1998 [83] | Prospective cohort | Single centre | *** | In-hospital | 74 | 33 | 38 (19–68 Range) | 50 (67.6%) | Age, PCP III levels, neutrophils, lung injury score | Day 3 following ARDS onset |
| McClintock 2006 [84] | RCT (ARMA) | Multicentre | AECC | Mortality | 579 | NR | 51 ± 17 | 333 (57.5%) | Ventilator group assignment | Day 0 following inclusion |
| McClintock 2007 [85] | RCT (ARMA) | Multicentre | AECC | Mortality | 576 | NR | 52 ± 17 | 328 (56.9%) | Gender, ventilator group assignment, eGFR, age, APACHE III score, vasopressor use, sepsis | Day 0 following inclusion |
| McClintock 2008 [86] | Prospective cohort | Two centre | AECC | In-hospital | 50 | 21 | 55 ± 16 | 28 (56.0%) | Age, gender, SAPS II | Within 48 h following diagnosis |
| Menk 2018 [87] | Retrospective cohort | Single centre | Berlin | ICU | 404 | 182 | 50 (37–61 IQR) | 265 (65.6%) | Age, gender, APACHE II score, SOFA, severe ARDS, peak airway pressure, pulmonary compliance | Within 24 h following admission |
| Metkus 2017 [88] | RCT (ALVEOLI, FACTT) | Multicentre | AECC | 60 days | 1057 | NR | 50.4 | 549 (51.9%) | Age, gender, trial group assignment | Within 24 h following inclusion |
| Mrozek 2016 [89] | Prospective cohort | Multicentre | AECC | 90 days | 119 | 42 | 57 ± 17 | 82 (68.9%) | Age, gender, SAPS II score, PaO2/FiO2, sepsis | Within 24 h following inclusion |
| Ong 2010 [90] | Prospective cohort | Two centre | AECC | 28-day in-hospital | 24 | NR | 51 ± 21 | 30 (53.6%) | Age, gender, PaO2/FiO2, tidal volume, plateau pressure, APACHE II score | At inclusion |
| Parsons 2005 [91] | RCT (ARMA) | Multicentre | AECC | 180 days or discharge | 562 | 196 | NR | NR | Ventilation strategy, APACHE III score, PaO2/FiO2, creatinine, platelet count, vasopressor use | At inclusion |
| Parsons 2005 [92] | RCT (ARMA) | Multicentre | AECC | In-hospital | 781 | 276 | 51.6 ± 17.3 | 319 (40.1%) | Ventilation strategy, APACHE III score, PaO2/FiO2, creatinine, platelet count, vasopressor use | Day 0 |
| Quesnel 2012 [93] | Prospective cohort | Single centre | AECC | 28 days | 92 | 37 | 67 (49–74 IQR) | 61 (66.3%) | Age, SAPS II score, malignancy, SOFA score, BAL characteristics | NR |
| Rahmel 2018 [94] | Retrospective cohort | Single centre | AECC | 30 days | 119 | 37 | 43.7 ± 13.3 | 71 (59.7%) | Age, SOFA score | Within 24 h following admission |
| Reddy 2019 [95] | Prospective cohort | Single centre | Berlin | 30 days | 39 | 19 | 55 (47.5-61.5) | 25 (64.1%) | Not specified | Within 24 h of ARDS diagnosis |
| Rivara 2012 [96] | Prospective cohort | Single centre | AECC | 60 days | 177 | 70 | 71.5 (59–80 IQR) | 98 (55.4%) | APACHE III score | Within 48 h following diagnosis |
| Rogers 2019 [97] | RCT (SAILS) | Multicentre | AECC | 60 days | 683 | NR | 56 (43–65) | 335 (49.0%) | Age, race, APACHE III score, GFR, randomization, shock | Within 48 h following ARDS diagnosis |
| Sapru 2015 [98] | RCT (FACTT) | Multicentre | AECC | 60 days | 449 | 109 | 49.8 ± 15.6 | 242 (53.9%) | Age, gender, APACHE III score, pulmonary sepsis, fluid management strategy | Upon inclusion |
| Suratt 2009 [99] | RCT (ARMA) | Multicentre | AECC | In-hospital | 645 | 222 | 51 ± 17 | 381 (59.1%) | Ventilation strategy, age, gender | Day 0 |
| Tang 2014 [100] | Prospective cohort | Multicentre | Berlin | In-hospital | 42 | 20 | 72.5 ± 10.8 | 27 (64.3%) | APACHE II score, PaO2/FiO2, CRP, WBC, procalcitonin | Within 24 h following diagnosis |
| Tsangaris 2009 [101] | Prospective cohort | Single centre | AECC | 28 days | 52 | 27 | 66.1 ± 16.9 | 32 (59.6%) | APACHE II score, age, genotype | Within 48 h following admission |
| Tsangaris 2017 [102] | Prospective cohort | Single centre | NR | 28 days | 53 | 28 | 64.6 ± 16.8 | 33 (62.3%) | Lung injury score | Within 48 h following diagnosis |
| Tsantes 2013 [103] | Prospective cohort | Single centre | AECC | 28 days | 69 | 34 | 64.4 ± 17.9 | 43 (62.3%) | Age, gender, APACHE II score, SOFA score, pulmonary parameters, serum lactate | Within 48 h following diagnosis |
| Tseng 2014 [104] | Prospective cohort | Single centre | AECC ARDS | ICU | 56 | 16 | 70.6 ± 9.2 | 31 (55.4%) | APACHE II score, SOFA score, SAPS II score | Day 1 following ICU admission |
| Wang 2017 [105] | Prospective cohort | Multicentre | Berlin | 60 days | 167 | 62 | 76.5 (19–95 range) | 112 (67.1%) | Age, gender, APACHE II score | Day 1 following diagnosis |
| Wang 2018 [106] | Retrospective cohort | Single centre | AECC | Mortality | 247 | 146 | 62 (48–73 IQR) | 162 (65.6%) | Age, cirrhosis, creatinine, PaO2/FiO2 | Within 24 h following diagnosis |
| Ware 2004 [107] | RCT (ARMA) | Multicentre | AECC | In-hospital | 559 | 193 | 51 ± 17 | 332 (59.4%) | Ventilator strategy, APACHE III score, PaO2/FiO2, creatinine, platelet count | Day 0 of inclusion |
| Xu 2017 [108] | Retrospective cohort | Single centre | Berlin | 28 days | 63 | 27 | 54 (42–67 IQR) | 37 (58.7%) | APACHE II score, PaO2/FiO2, procalcitonin | Within 48 following admission |
| Total† | 15,344 | 3914 | ||||||||
| 36.0% |
*Respiratory failure requiring positive pressure ventilation, PF ratio < 200 mmHg, bilateral pulmonary infiltration on chest X-ray, no clinical evidence of left atrial hypertension
**PF ratio < 150 mmHg, PF < 200 mmHg with 5 PEEP, diffuse parenchymal infiltrates, pulmonary artery wedge pressure < 18 mmHg, no clinical evidence of congestive heart failure
***PF ratio < 150 mmHg, PF ratio < 200 mmHg with 5 cmH2O PEEP, diffuse parenchymal infiltrates, pulmonary artery wedge pressure < 18 mmHg, or no clinical evidence of congestive heart failure
†Some studies included patients from the same cohort
Abbreviations: AECC American European Consensus Conference definition of ARDS, APACHE acute physiology and chronic health evaluation, ARDS acute respiratory distress syndrome, BAL bronchoalveolar lavage, BMI body mass index, CRP C-reactive protein, CVVHD continuous veno-venous haemodialysis, DNR do not resuscitate, ECMO extra corporeal membrane oxygenation, eGFR estimated glomerular filtration rate, FiO2 fraction of inspired oxygen, ICU intensive care unit, PCP procollagen, No. number, SAPS simplified acute physiology score, SOFA sequential organ failure assessment, WBC white blood cell count