Objective: To investigate the prognostic factors in acute respiratory distress syndrome (ARDS) patients focusing on the use of prone positioning (PP).
Design and setting: Retrospective study conducted in an intensive care unit of a university hospital.
Patients: All consecutive mechanically ventilated ARDS patients surviving on day 7 after the diagnosis of ARDS.
Methods: The study included all ARDS patients who survived more than 7 days after ARDS diagnosis between January 1995 and December 2002. Demographic and respiratory variables were collected on day 1, and the management of ARDS was analyzed during the first 7 days ( n=125). We performed a univariate analysis and a stepwise logistic regression analysis comparing survivors and nonsurvivors on day 28 and at 2 and 6 months.
Results: Mortality rates on day 28 and at 2 and 6 months were 21.6%, 32%, and 44% respectively. A SAPS II score less than 49, McCabe score, and the use of PP introduced in the first 7 days of ARDS management appeared to be independently correlated with a decrease in mortality.
Conclusions: The SAPS II score, the McCabe score, and use of PP are independently correlated with the outcome in ARDS patients.