%0 Journal Article
%T Contributions to the epidemiology of acute respiratory failure
%A Klaus Lewandowski
%J Critical Care
%D 2003
%I BioMed Central
%R 10.1186/cc2352
%X For the intensivist with an interest in epidemiology, the recent report from Flaatten and coworkers [1], published in this issue of Critical Care, may serve as a focal point that highlights several interesting features of that special field. These include but are not limited to incidence figures and mortality rates for acute respiratory failure (ARF), the contribution of additional single organ failures or multiple organ dysfunction syndrome to mortality, the difficulties of comparing results of epidemiological studies, and chances missed to address urgent questions. In this commentary I highlight these and thereby, hopefully, enhance our understanding of the often complex associations that epidemiologists and readers of epidemiological articles will encounter from time to time.First, however, I summarize the main findings of the report under discussion. In a 30-month prospective cohort study, of 832 adult patients treated in a Norwegian intensive care unit (ICU) 63% had severe ARF according to the Sequential Organ Failure Assessment (SOFA; i.e. a ratio of arterial oxygen tension [PaO2] to fractional inspired oxygen [FiO2] ¡Ü 200 mmHg [¡Ü 26.6 kPa] with respiratory support). If no additional organ failures occurred then the ICU mortality rate for ARF was 3.2%, and hospital and 90-day mortality rates were 14.7% and 21.8%, respectively. However, if severe ARF was accompanied by other organ failures then mortality increased with each additional organ failure, and was as high as 75% when five or six organs were in failure.Incidence figures for various forms of ARF have come under intense scrutiny in recent years because they may allow assessment of the magnitude of public health consequences, permit observation of temporal, geographic and demographic variations, and inform decisions on distribution of hospital resources. A consensus definition for ARF is not yet available. However, two European studies, one in 72 ICUs in Berlin, Germany [2] and the other in 132 ICUs in Sw
%K acute lung injury
%K acute respiratory distress syndrome
%K acute respiratory failure
%K epidemiology
%K mortality
%U http://ccforum.com/content/7/4/288