To investigate the influencing factors of 28-day survival and prognostic factors in patients with acute respiratory distress syndrome (ARDS).

The clinical data of 100 patients with ARDS admitted to intensive care unit in Chengdu 363 Hospital from April 2017 to April 2020 were retrospectively analyzed.According to the 28-day survival situation, the patients were divided into good prognosis group (survival, n=45) and poor prognosis group (death, n=55). The basic information of the two groups was collected.The difference of basic information between the two groups was compared.The difference information was included in the logistic model, and the quantitative evaluation was performed.The prognosis was taken as the dependent variable (Y, bad=1), and the age, whether combined with lower respiratory tract infections, whether to use immunosuppressive drugs, the time from onset to treatment, the time of invasive mechanical ventilation, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) score, oxygenation index (OI) and stroke volume variability (SVV) were independent variables (X), to identify the risk factors of poor prognosis in patients with ARDS.Finally, the accuracy of predicting the prognosis of patients with ARDS was analyzed by consistency.

In the poor prognosis group, the proportions of patients aged ≥65 years old, combined with lower respiratory tract infections, using immunosuppressive drugs, and SVV<15% were significantly higher, the time from onset to treatment was significantly longer, the time of invasive mechanical ventilation was significantly shorter, APACHEⅡ score was significantly higher, and OI was significantly lower compared with the good prognosis group, and the differences were statistically significant (allP<0.05). The multi-factor logistic analysis confirmed that ≥65 years old, lower respiratory tract infections, the use of immunosuppressive drugs, time from onset to treatment >7 days, time of invasive mechanical ventilation <100 hours, APACHE Ⅱ score ≥20, OI<130 mmHg (1 mmHg=0.098 kPa), SVV<15% were risk factors for poor prognosis in ARDS patients (allP<0.05). The consistency analysis showed that age, lower respiratory tract infections, the use of immunosuppressive drugs, time from onset to treatment, time of invasive mechanical ventilation, APACHE Ⅱ score, OI, SVV could be used to predict the prognosis of ARDS patients (Kappa=0.543, 0.544, 0.607, 0.548, 0.545, 0.606, 0.661, 0.573).

There are many influencing factors for 28-day death of ARDS patients in intensive care unit, such as age, whether combined with lower respiratory tract infections, whether to use immunosuppressive drugs, time from onset to treatment, time of invasive mechanical ventilation, APACHE Ⅱ score, OI and SVV, clinicians should pay attention to.

Respiratory distress syndrome, adult; Logistic model; Risk factors; Consistency; Prognosis