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Comparison of Clinical Criteria for the Acute Respiratory Distress Syndrome with Autopsy Findings

Andrés Esteban, MD, PhD; Pilar Fernández-Segoviano, MD, PhD; Fernando Frutos-Vivar, MD; José Antonio Aramburu, MD; Laura Nájera, MD; Niall D. Ferguson, MD, MSc; Inmaculada Alía, MD; Federico Gordo, MD; and Fernando Ríos, MD
[+] Article and Author Information

From the Hospital Universitario de Getafe, Madrid, Spain, and University Health Network, University of Toronto, Toronto, Ontario, Canada.


Acknowledgments: The authors thank Victor Abraira from Unidad de Bioestadística of Hospital Ramón y Cajal, Madrid, Spain, for statistical advice.

Grant Support: By Red Gira G03/063 and Red Respira C03/11, Instituto de Salud Carlos III, Spain. Dr. Ferguson was supported by a Canadian Institutes of Health Research, Canadian Lung Association, postdoctoral fellowship.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Andrés Esteban, MD, PhD, Unidad de Cuidados Intensivos Hospital Universitario de Getafe, Carretera de Toledo Km 12,500 Getafe 28905, Madrid, Spain; e-mail, aesteban@ucigetafe.com.

Author Contributions: Conception and design: A. Esteban, P. Fernández-Segoviano, F. Frutos-Vivar, L. Nájera, I. Alía, F. Gordo, F. Ríos.

Analysis and interpretation of the data: A. Esteban, P. Fernández-Segoviano, F. Frutos-Vivar, J.A. Aramburu, L. Nájera, N.D. Ferguson, I. Alía, F. Gordo, F. Ríos.

Drafting of the article: A. Esteban, F. Frutos-Vivar, I. Alía.

Critical revision of the article for important intellectual content: A. Esteban, P. Fernández-Segoviano, F. Frutos-Vivar, J.A. Aramburu, L. Nájera, N.D. Ferguson.

Final approval of the article: N.D. Ferguson.

Statistical expertise: N.D. Ferguson

Current Author Addresses: Drs. Esteban, Frutos-Vivar, and Alía: Intensive Care Unit, Hospital Universitario de Getafe, Carretera de Toledo Km 12,500, Getafe 28905, Madrid, Spain.

Drs. Fernández-Segoviano, Aramburu, and Nájera: Department of Pathology, Hospital Universitario de Getafe, Carretera de Toledo Km 12,500, Getafe 28905, Madrid, Spain.

Dr. Ferguson: Respirology and Critical Care Medicine, University Health Network, Toronto Western Hospital, EC2-024, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada.

Dr. Gordo: Intensive Care Unit, Fundación Hospital de Alcorcón, Budapest, 1, Alcorcón 28922, Madrid, Spain.

Dr. Ríos: Hospital Profesor Posadas, Poniente Illia s/n y Marconi, El Palomar 1706, Buenos Aires, Argentina.


Ann Intern Med. 2004;141(6):440-445. doi:10.7326/0003-4819-141-6-200409210-00009
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During the study period, 8157 patients were admitted to the intensive care unit and 1399 (17%) died. We subsequently excluded 104 organ donors and 90 patients with legally mandated autopsies. We obtained consent and performed a clinical autopsy in 406 (34%) of the remaining patients. Twenty-four (6%) of these patients were excluded from the analysis because the hospital clinical records were lost and the information needed to determine both risk factor and clinical definition status was therefore unavailable. Table 1 shows the patient demographic and clinical characteristics. Organ donors and patients who required legally mandated autopsy were younger than other patients, and more of them had trauma as a risk factor for ARDS. Organ donors were more likely to be admitted to the intensive care unit with a neurologic problem, and patients with legally mandated autopsy were more likely to be men. Patients whose relatives declined autopsy were similar to the patients included in the study. Study patients had a median duration of mechanical ventilation of 4 days (interquartile range, 1 to 11 days) and a median length of stay in the intensive care unit of 5 days (interquartile range, 1 to 12 days).

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Summary for Patients

How Well Do Clinical and Lung Tissue Criteria for the Acute Respiratory Distress Syndrome Match?

The summary below is from the full report titled “Comparison of Clinical Criteria for the Acute Respiratory Distress Syndrome with Autopsy Findings.” It is in the 21 September 2004 issue of Annals of Internal Medicine (volume 141, pages 440-445). The authors are A. Esteban, P. Fernández- Segoviano, F. Frutos-Vivar, J.A. Aramburu, L. Nájera, N.D. Ferguson, I. Alía, F. Gordo, and F. Ríos.

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