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Author Notes:

Colin R. Cooke, MD, MSc; Division of Pulmonary & Critical Care Medicine, University of Michigan, Ann Arbor, MI. 6312 Medical Sciences Bldg. I, 1150 W. Medical Center Drive, Ann Arbor, MI, 48109-5604. Email: cookecr@umich.edu.

Dr. Cooke had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

This work was performed at the University of Michigan and Emory University.

Dr. Eisner is a full-time employee of Genentech, Inc.

Dr. Cooke has not disclosed any potential conflicts of interest.

Subjects:

Research Funding:

This work was possible due to the support of the Robert Wood Johnson Foundation Clinical Scholars program (Dr. Cooke), Atlanta Clinical and Translational Science Institute KL2 RR-025009 (Dr. Erickson), and NIH FD R01-003440 (Dr. Martin).

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Critical Care Medicine
  • General & Internal Medicine
  • acute lung injury
  • epidemiology
  • health status disparities
  • international classification of diseases
  • National Hospital Discharge Survey
  • respiratory failure
  • ACUTE LUNG INJURY
  • TIDAL VOLUME VENTILATION
  • INTENSIVE-CARE-UNIT
  • QUALITY-OF-CARE
  • DISTRESS-SYNDROME
  • SEVERE SEPSIS
  • MULTIPLE IMPUTATION
  • BLACK PATIENTS
  • MORTALITY
  • STATES

Trends in the incidence of noncardiogenic acute respiratory failure: the role of race

Tools:

Journal Title:

Critical Care Medicine

Volume:

Volume 40, Number 5

Publisher:

, Pages 1532-1538

Type of Work:

Article | Post-print: After Peer Review

Abstract:

We sought to examine trends in the race-specific incidence of acute respiratory failure in the United States. Design: Retrospective cohort study. Setting: We used the National Hospital Discharge Survey database (1992-2007), an annual survey of approximately 500 hospitals weighted to provide national hospitalization estimates. Patients: All incident cases of noncardiogenic acute respiratory failure hospitalized in the United States. INTERVENTIONS:: None. Measurements and Main Results: We identified noncardiogenic acute respiratory failure by the presence of International Classification of Diseases, Ninth Revision, codes for respiratory failure or pulmonary edema (518.4, 518.5, 518.81, and 518.82) and mechanical ventilation (96.7×), excluding congestive heart failure. Incidence rates were calculated using yearly census estimates standardized to the age and sex distribution of the 2000 census population. Annual cases of noncardiogenic acute respiratory failure increased from 86,755 in 1992 to 323,474 in 2007. Noncardiogenic acute respiratory failure among black Americans increased from 56.4 (95% confidence interval 39.7-73.1) to 143.8 (95% confidence interval 123.8-163.8) cases per 100,000 in 1992 and 2007, respectively. Among white Americans, the incidence of noncardiogenic acute respiratory failure increased from 31.2 (95% confidence interval 26.2-36.5) to 94.0 (95% confidence interval 86.7-101.2) cases per 100,000 in 1992 and 2007, respectively. The average annual incidence of noncardiogenic acute respiratory failure over the entire study period was 95.1 (95% confidence interval 93.9-96.4) cases per 100,000 for black Americans compared to 66.5 (95% confidence interval 65.8-67.2) cases per 100,000 for white Americans (rate ratio 1.43, 95% confidence interval 1.42-1.44). Overall in-hospital mortality was greater for other-race Americans, but only among patients with two or more organ failures (57% [95% confidence interval 56%-59%] for other race, 51% [95% confidence interval 50%-52%] for white, 50% [95% confidence interval 49%-51%] for black). Conclusions: The incidence of noncardiogenic acute respiratory failure in the United States increased between 1992 and 2007. Black and other-race Americans are at greater risk of developing noncardiogenic acute respiratory failure compared to white Americans.

Copyright information:

© 2012 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins.

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