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International Journal of Emergency Medicine

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Open Access 01-12-2012 | Original Research

Towards prevention of acute lung injury: frequency and outcomes of emergency department patients at-risk – a multicenter cohort study

Authors: Peter C Hou, Marie-Carmelle Elie-Turenne, Aya Mitani, Jonathan M Barry, Erica Y Kao, Jason E Cohen, Gyorgy Frendl, Ognjen Gajic, Nina T Gentile, On Behalf of US Critical Illness and Injury Trials Group: Lung Injury Prevention Study Investigators (USCIITG–LIPS 1)

Published in: International Journal of Emergency Medicine | Issue 1/2012

Abstract

Background

Few emergency department (ED) evaluations on acute lung injury (ALI) have been carried out; hence, we sought to describe a cohort of hospitalized ED patients at risk for ALI development.

Methods

Patients presenting to the ED with at least one predisposing condition to ALI were included in this study, a subgroup analysis of a multicenter observational cohort study (USCIITG-LIPS 1). Patients who met ALI criteria within 6 h of initial ED assessment, received end-of-life care, or were readmitted during the study period were excluded. Primary outcome was frequency of ALI development; secondary outcomes were ICU and hospital mortality.

Results

Twenty-two hospitals enrolled 4,361 patients who were followed from the ED to hospital discharge. ALI developed in 303 (7.0 %) patients at a median onset of 2 days (IQR 2–5). Of the predisposing conditions, frequency of ALI development was highest in patients who had aortic surgery (43 %) and lowest in patients with pancreatitis (2.8 %). Compared to patients who did not develop ALI, those who did had higher ICU (24 % vs. 3.0 %, p < 0.001) and hospital (28 % vs. 4.6 %, p < 0.001) mortality, and longer hospital length of stay (16 vs. 5 days, p < 0.001). Among the 22 study sites, frequency of ALI development varied from less than 1 % to more than 12 % after adjustment for APACHE II.

Conclusions

Seven percent of hospitalized ED patients with at least one predisposing condition developed ALI. The frequency of ALI development varied significantly according to predisposing conditions and across institutions. Further research is warranted to determine the factors contributing to ALI development.

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Title: Towards prevention of acute lung injury: frequency and outcomes of emergency department patients at-risk – a multicenter cohort study
Authors: Peter C Hou
Marie-Carmelle Elie-Turenne
Aya Mitani
Jonathan M Barry
Erica Y Kao
Jason E Cohen
Gyorgy Frendl
Ognjen Gajic
Nina T Gentile
On Behalf of US Critical Illness and Injury Trials Group: Lung Injury Prevention Study Investigators (USCIITG–LIPS 1)
Publication date: 01-12-2012
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Emergency Medicine / Issue 1/2012
Print ISSN: 1865-1372
Electronic ISSN: 1865-1380
DOI: https://doi.org/10.1186/1865-1380-5-22

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Towards prevention of acute lung injury: frequency and outcomes of emergency department patients at-risk – a multicenter cohort study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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