The prevalence and impact of mortality of the acute respiratory distress syndrome on admissions of patients with ischemic stroke in the united states

Methods: Retrospective cohort study of admissionswith a diagnosis of AIS and ARDS from 1994 to 2008 identified through the Nationwide Inpatient Sample.

Results: During the15-year study period, we found 55 58 091 admissions of patients with AIS. The prevalence of ARDS in admissions of patients withAIS increased from 3% in 1994 to 4% in 2008 (P <.001). The ARDS was more common among younger men, nonwhites, andassociated with history of congestive heart failure, hypertension, chronic obstructive pulmonary disease, renal failure, chronicliver disease, systemic tissue plasminogen activator, craniotomy, angioplasty or stent, sepsis, and multiorgan failures. Mortalitydue to AIS and ARDS decreased from 8% in 1994 to 6% in 2008 (P <.001) and 55% in 1994 to 45% in 2008 (P <.001), respectively.The ARDS in AIS increased in-hospital mortality (odds ratio, 14; 95% confidence interval, 13.5-14.3). A significantly higher lengthof stay was seen in admissions of patients with AIS having ARDS.

Conclusion: Our analysis demonstrates that ARDS is rare afterAIS. Despite an overall significant reduction in mortality after AIS, ARDS carries a higher risk of death in this patient population.

Purpose: To determine the epidemiology of the acute respiratory distress syndrome (ARDS) and impact on in-hospital mortality inadmissions of patients with acute ischemic stroke (AIS) in the United States.