| Title |
Impact of the driving pressure on mortality in obese and non-obese ARDS patients: a retrospective study of 362 cases
|
|---|---|
| Published in |
Intensive Care Medicine, June 2018
|
| DOI | 10.1007/s00134-018-5241-6 |
| Pubmed ID | |
| Authors |
Audrey De Jong, Jeanne Cossic, Daniel Verzilli, Clément Monet, Julie Carr, Mathieu Conseil, Marion Monnin, Moussa Cisse, Fouad Belafia, Nicolas Molinari, Gérald Chanques, Samir Jaber |
| Abstract |
The relation between driving pressure (plateau pressure-positive end-expiratory pressure) and mortality has never been studied in obese ARDS patients. The main objective of this study was to evaluate the relationship between 90-day mortality and driving pressure in an ARDS population ventilated in the intensive care unit (ICU) according to obesity status. We conducted a retrospective single-center study of prospectively collected data of all ARDS patients admitted consecutively to a mixed medical-surgical adult ICU from January 2009 to May 2017. Plateau pressure, compliance of the respiratory system (Crs) and driving pressure of the respiratory system within 24 h of ARDS diagnosis were compared between survivors and non-survivors at day 90 and between obese (body mass index ≥ 30 kg/m2) and non-obese patients. Cox proportional hazard modeling was used for mortality at day 90. Three hundred sixty-two ARDS patients were included, 262 (72%) non-obese and 100 (28%) obese patients. Mortality rate at day 90 was respectively 47% (95% CI, 40-53) in the non-obese and 46% (95% CI, 36-56) in the obese patients. Driving pressure at day 1 in the non-obese patients was significantly lower in survivors at day 90 (11.9 ± 4.2 cmH2O) than in non-survivors (15.2 ± 5.2 cmH2O, p < 0.001). Contrarily, in obese patients, driving pressure at day 1 was not significantly different between survivors (13.7 ± 4.5 cmH2O) and non-survivors (13.2 ± 5.1 cmH2O, p = 0.41) at day 90. After three multivariate Cox analyses, plateau pressure [HR = 1.04 (95% CI 1.01-1.07) for each point of increase], Crs [HR = 0.97 (95% CI 0.96-0.99) for each point of increase] and driving pressure [HR = 1.07 (95% CI 1.04-1.10) for each point of increase], respectively, were independently associated with 90-day mortality in non-obese patients, but not in obese patients. Contrary to non-obese ARDS patients, driving pressure was not associated with mortality in obese ARDS patients. |
X Demographics
The data shown below were collected from the profiles of 53 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 7 | 13% |
| Spain | 4 | 8% |
| Colombia | 3 | 6% |
| Brazil | 3 | 6% |
| United Kingdom | 2 | 4% |
| Denmark | 2 | 4% |
| Venezuela, Bolivarian Republic of | 2 | 4% |
| Netherlands | 2 | 4% |
| Kazakhstan | 1 | 2% |
| Other | 8 | 15% |
| Unknown | 19 | 36% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 39 | 74% |
| Practitioners (doctors, other healthcare professionals) | 9 | 17% |
| Scientists | 4 | 8% |
| Science communicators (journalists, bloggers, editors) | 1 | 2% |
Mendeley readers
The data shown below were compiled from readership statistics for 90 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 90 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 16 | 18% |
| Other | 10 | 11% |
| Student > Postgraduate | 8 | 9% |
| Student > Master | 7 | 8% |
| Student > Bachelor | 5 | 6% |
| Other | 17 | 19% |
| Unknown | 27 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 48 | 53% |
| Nursing and Health Professions | 7 | 8% |
| Biochemistry, Genetics and Molecular Biology | 2 | 2% |
| Computer Science | 2 | 2% |
| Agricultural and Biological Sciences | 1 | 1% |
| Other | 2 | 2% |
| Unknown | 28 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 30. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 August 2018.
All research outputs
#1,198,484
of 24,066,486 outputs
Outputs from Intensive Care Medicine
#1,078
of 5,188 outputs
Outputs of similar age
#26,797
of 332,680 outputs
Outputs of similar age from Intensive Care Medicine
#44
of 147 outputs
Altmetric has tracked 24,066,486 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,188 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 28.9. This one has done well, scoring higher than 79% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 332,680 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 91% of its contemporaries.
We're also able to compare this research output to 147 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 70% of its contemporaries.