Objective: To identify specific comorbid factors that
are present in US decedents with ARDS.
searched the 1993 National Mortality Followback Study for all decedents
who had a code for ARDS mentioned on their death certificate. We also
searched for comorbid conditions both on the death certificates
(sepsis, medical or surgical misadventures, cirrhosis) and in the study
database (current or former smoking, use of alcohol at least 3 d/wk,
race, gender, and age). We calculated proportional mortality ratios
(PMRs) for these risk factors.
Results: Of the 19,003
decedents for whom data were available, 252 decedents, representing an
estimated 19,460 US decedents, had ARDS listed on their death
certificate. PMRs among decedents with ARDS were significantly
increased for medical or surgical misadventures (PMR, 11.8; 95%
confidence interval [CI], 3.8 to 36.7), sepsis (PMR, 5.6; 95% CI,
2.0 to 16.0), nonwhite race (PMR, 2.6; 95% CI, 1.4 to 5.0), and
cirrhosis (PMR, 2.2; 95% CI, 1.1 to 4.6). PMRs were increased but not
statistically significant for current smokers (PMR, 1.2; 95% CI, 0.5
to 3.0) or former smokers (PMR, 1.8; 95% CI, 0.7 to 4.3) compared to
never smokers, and drinking alcohol on ≥ 3 d/wk in the year prior to
death, when compared to drinking alcohol less than < 3 d/wk (PMR,
1.8; 95% CI, 0.6 to 4.9).
Conclusions: The results of
this study confirm the positive associations between ARDS mortality and
the presence of sepsis and cirrhosis, and suggest possible new
relationships between ARDS mortality and nonwhite individuals and
patients with medical or surgical misadventures.