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Etiology and Outcomes of ARDS in a Rural-Urban Fringe Hospital of South India.
[scrub typhus]
Objectives
.
Etiology
and
outcomes
of
acute
lung
injury
in
tropical
countries
may
be
different
from
those
of
western
nations
.
We
describe
the
etiology
and
outcomes
of
illnesses
causing
acute
lung
injury
in
a
rural
populace
.
Study
Design
.
A
prospective
observational
study
.
Setting
.
Medical
ICU
of
a
teaching
hospital
in
a
rural-urban
fringe
location
.
Patients
.
Patients
≥
13
years
,
admitted
between
December
2011
and
May
2013
,
satisfying
AECC
criteria
for
ALI
/
ARDS
.
Results
.
Study
had
61
patients
;
46
had
acute
lung
injury
at
admission
.
Scrub
typhus
was
the
commonest
cause
(
7
/
61
)
and
tropical
infections
contributed
to
26
%
of
total
cases
.
Increasing
ARDS
severity
was
associated
with
older
age
,
higher
FiO
2
and
APACHE
/
SOFA
scores
,
and
longer
duration
of
ventilation
.
Nonsurvivors
were
generally
older
,
had
shorter
duration
of
illness
,
a
nontropical
infection
,
and
higher
total
WBC
counts
,
required
longer
duration
of
ventilation
,
and
had
other
organ
dysfunction
and
higher
mean
APACHE
scores
.
The
mortality
rate
of
ARDS
was
36
.
6
%
(
22
/
61
)
in
our
study
.
Conclusion
.
Tropical
infections
form
a
major
etiological
component
of
acute
lung
injury
in
a
developing
country
like
India
.
Etiology
and
outcomes
of
ARDS
may
vary
depending
upon
the
geographic
location
and
seasonal
illnesses
.
