National survey of outcomes and practices in acute respiratory distress syndrome in Singapore

PLoS One. 2017 Jun 16;12(6):e0179343. doi: 10.1371/journal.pone.0179343. eCollection 2017.

Abstract

Introduction: In the past 20 years, our understanding of acute respiratory distress syndrome (ARDS) management has improved, but the worldwide incidence and current outcomes are unclear. The reported incidence is highly variable, and no studies specifically characterise ARDS epidemiology in Asia. This observation study aims to determine the incidence, mortality and management practices of ARDS in a high income South East Asian country.

Methods: We conducted a prospective, population based observational study in 6 public hospitals. During a one month period, we identified all ARDS patients admitted to public hospital intensive care units (ICU) in Singapore, according to the Berlin definition. Demographic information, clinical management data and ICU outcome data was collected.

Results: A total of 904 adult patients were admitted to ICU during the study period and 15 patients met ARDS criteria. The unadjusted incidence of ARDS was 4.5 cases per 100,000 population, accounting for 1.25% of all ICU patients. Most patients were male (75%), Chinese (62%), had pneumonia (73%), and were admitted to a Medical ICU (56%). Management strategies varied across all ICUs. In-hospital mortality was 40% and median length of ICU stay was 7 days.

Conclusion: The incidence of ARDS in a developed S.E Asia country is comparable to reported rates in European studies.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Female
  • Hospital Mortality*
  • Humans
  • Intensive Care Units
  • Length of Stay*
  • Male
  • Middle Aged
  • Prospective Studies
  • Respiratory Distress Syndrome / mortality*
  • Respiratory Distress Syndrome / therapy*
  • Retrospective Studies
  • Sex Factors
  • Singapore / epidemiology

Grants and funding

The authors acknowledge the following as the total funding sources for this study: 1. SICM NICER grant: logistical, non-monetary, support from the Society of Intensive Care Medicine Singapore. This was in the form of Ngee Ann Polytechnic students (8) who collected the data for the study for one month. 2. NMRC (National medical research council) grant for Dr, Matthew Cove (partial support for this study): This was in the shape of salary support for all his research related activity. (NMRC/TA/0015/2013) (MEC). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. There was no additional external funding received for this study.