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Previous Volume 353:1685-1693 October 20, 2005 Number 16 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Herridge, M. S. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Acute lung injury is a critical illness syndrome consisting of acute hypoxemic respiratory failure with bilateral pulmonary infiltrates that are not attributed to left atrial hypertension. Despite recent advances in our understanding of the mechanism and treatment of acute lung injury, its incidence and outcomes in the United States have been unclear.

Methods We conducted a prospective, population-based, cohort study in 21 hospitals in and around King County, Washington, from April 1999 through July 2000, using a validated screening protocol to identify patients who met the consensus criteria for acute lung injury.

Results A total of 1113 King County residents undergoing mechanical ventilation met the criteria for acute lung injury and were 15 years of age or older. On the basis of this figure, the crude incidence of acute lung injury was 78.9 per 100,000 person-years and the age-adjusted incidence was 86.2 per 100,000 person-years. The in-hospital mortality rate was 38.5 percent. The incidence of acute lung injury increased with age from 16 per 100,000 person-years for those 15 through 19 years of age to 306 per 100,000 person-years for those 75 through 84 years of age. Mortality increased with age from 24 percent for patients 15 through 19 years of age to 60 percent for patients 85 years of age or older (P<0.001). We estimate that each year in the United States there are 190,600 cases of acute lung injury, which are associated with 74,500 deaths and 3.6 million hospital days.

Conclusions Acute lung injury has a substantial impact on public health, with an incidence in the United States that is considerably higher than previous reports have suggested.

Source Information

From the Division of Pulmonary and Critical Care Medicine (G.D.R., E.C., E.P., J.W., M.N., L.D.H.) and the Department of Radiology (E.J.S.), Harborview Medical Center; and the Department of Health Services, School of Public Health and Community Medicine, University of Washington (D.P.M.) — all in Seattle.

Address reprint requests to Dr. Rubenfeld at the Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, Box 359762, 325 9th Ave., Seattle, WA 98104-2499, or at nodrog{at}u.washington.edu.

Full Text of this Article

Related Letters:

Incidence and Outcomes of Acute Lung Injury
Mutlu G. M., Budinger G.R. S., Maybauer M. O., Maybauer D. M., Herndon D. N., Rubenfeld G. D., Caldwell E., Hudson L. D.
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N Engl J Med 2006; 354:416-417, Jan 26, 2006. Correspondence

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