WEDNESDAY, Oct. 19, 2005 (HealthDay News) -- The critical lung condition that most people call ARDS is more common and more deadly than has been thought, according to the first study of its kind.
A yearlong look at all cases of acute respiratory distress syndrome in one county in Washington prompted University of Washington doctors to estimate that, nationwide, there are 86 cases for every 100,000 patients treated in intensive care units, which translates to 190,000 cases in the United States each year. The overall in-hospital death rate was 38.5 percent, but it rose rapidly with age, with 60 percent of those 85 and older dying of it. More than 74,000 Americans die of the condition annually, the researchers said.
The proper name for the condition is "acute lung injury," said Dr. Gordon D. Rubenfeld, lead author of a report on the study in the Oct. 20 issue of the New England Journal of Medicine. It is caused by trauma to lung tissue, most often resulting from pneumonia or other diseases that attack the lungs. ARDS is the most severe form of the condition and accounts for about three-quarters of all cases, Rubenfeld said.
The study looked at 1,113 residents who were hospitalized for acute lung injury from April 1999 to July 2000. It found the incidence increased with age, from 16 per 100,000 person years for people aged 15 through 19 to 306 per 100,000 for those aged 75 through 84.
"We didn't expect there to be quite so many cases," Rubenfeld said. "It is quite a common disease. Many physicians think of this disease as important but rare. It is important and reasonably common, particularly in older folks. Mortality is high, and goes up with age."
Because the U.S. population is aging, "we will see more and more people die of it," Rubenfeld added.
While most people worry about dying of heart disease, "this condition has triple the mortality of a heart attack," he said.
Right now, the most effective treatment involves adjustments to the ventilator that helps patients with the condition breathe, Rubenfeld said. "It is just turning down the dial on the ventilator, just giving people very small breaths when they are on the breathing machine," he explained.
The study points up the need for "more funding so we know more about taking care of patients with this condition," Rubenfeld said.
"I always thought the incidence must be higher than previously believed," said Dr. John Hansen-Flaschen, chief of pulmonary and critical care medicine at the University of Pennsylvania Medical Center in Philadelphia. "I'm in an ICU [intensive care unit] now, and we have four cases currently."
There are no medications that can prevent or treat lung injury, Hansen-Flaschen added.
"We use mechanical ventilation and intravenous fluids, and that continues for several days or two to three months while we wait for the lungs to recover from the injury," he said.
Acute lung injury can cause a crisis in the family, he said. "People think they are isolated and alone," Hansen-Flaschen said. "One of the important things this paper does is to provide context for families that have this condition to contend with."
The number of deaths caused by acute lung injury in the United States each year is about the same as deaths caused by breast cancer, he noted.
More information
For more on ARDS and related conditions, visit the ARDS Support Center.
