ArticleAnnals of intensive care2023
Outcomes and time trends of acute respiratory distress syndrome patients with and without liver cirrhosis: an observational cohort.
Article in Annals of intensive care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 25 citations in OpenAlex.
- Noninvasive ventilation on reintubation in patients with obesity and hypoxemic respiratory failure following abdominal surgery: a post hoc analysis of a randomized clinical trial.Intensive care medicine · 2024Trial
- SOFA-2 Score and Mortality in Suspected Infection Stratified by Cirrhosis Status: A Multi-Institutional Observational Cohort Study.Liver international : official journal of the International Association for the Study of the Liver · 2026Observational
- Characteristics and prognosis of patients with cirrhosis presenting with acute respiratory distress syndrome: A bicentric retrospective study.Journal of intensive medicine · 2026Article
- Is postoperative ARDS different from medical ARDS?Critical care (London, England) · 2026Article
- Morphological subphenotypes of acute pancreatitis-related acute respiratory distress syndrome.Critical care (London, England) · 2026Article
- Refining the use of neuromuscular blockade in ARDS: lessons from a post hoc Markov model re-analysis of the ACURASYS trial.Intensive care medicine · 2025Article
- Liver as a key organ for systemic antimicrobial defense.Hepatology communications · 2025Review
- Incidence and outcomes of extubation failure in mechanically ventilated patients with cirrhosis: a post-hoc analysis of a prospective multicenter study.Annals of intensive care · 2025Article
- Bench evaluation of six non-invasive ventilation home ventilators: comparison with an ICU ventilator and unsupervised clustering.BMJ open respiratory research · 2025Article
- Temporal stability of phenotypes of acute respiratory distress syndrome: clinical implications for early corticosteroid therapy and mortality.Intensive care medicine · 2025Article
- Factors associated with women authorship over 25 years in high-impact critical care randomized controlled trials: the pipeline is still leaking.Critical care (London, England) · 2025Article
- Short- and long-term outcomes and 15-year time trends of kidney replacement therapy in critically ill patients with obesity: an observational cohort.Intensive care medicine · 2025Observational
- Anticoagulation management and outcomes in critically ill patients with acute mesenteric ischemia: an international study.Intensive care medicine · 2025Article
- Identifying a unique signature of sepsis in patients with pre-existing cirrhosis.Critical care (London, England) · 2025Article
- Impact of acute respiratory distress syndrome on outcome in critically ill patients with liver cirrhosis.Scientific reports · 2025Article
- Risk of Severe COVID-19-Related Outcomes among Patients with Cirrhosis: A Population-Based Cohort Study in Canada.Viruses · 2024Article
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Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn studies prior to lung-protective ventilation, liver cirrhosis in acute respiratory distress syndrome (ARDS) was associated with high mortality rates. Since patients with cirrhosis have been excluded from many trials on ARDS, their outcome when treated with lung-protective ventilation is unclear. The objectives were to assess whether cirrhosis is associated with mortality in ARDS and trends over time in mortality and severity.
methodsWe conducted a retrospective analysis of a prospective observational cohort conducted in a 20-bed tertiary ICU from October 2003 to December 2021. All consecutive adult critically ill patients with ARDS were included. ARDS was defined by the Berlin criteria. The primary outcome was 90 day mortality, assessed with Kaplan-Meier curves and multivariate Cox analysis. Time trends were assessed on 90 day mortality, Sequential Organ-Function Assessment score (SOFA) and non-hepatic SOFA. Ventilation settings were compared between patients with and without cirrhosis.
resultsOf the 7155 patients screened, 863 had a diagnosis of ARDS. Among these ARDS patients, 157(18%) had cirrhosis. The overall 90 day mortality was of 43% (378/863), 57% (90/157) in patients with cirrhosis and 41% (288/706) in patients without cirrhosis (p < 0.001). On survival curves, cirrhosis was associated with 90 day mortality (p < 0.001). Cirrhosis was independently associated with 90 day mortality in multivariate analysis (hazard ratio = 1.56, 95% confidence interval 1.20-2.02). There was no change in mortality over time in ARDS patients with and without cirrhosis. SOFA (p = 0.04) and non-hepatic SOFA (p = 0.02) increased over time in ARDS patients without cirrhosis, and remained stable in ARDS patients with cirrhosis. Tidal volume, positive end-expiratory pressure, plateau pressure and driving pressure were not different between ARDS patients with and without cirrhosis.
conclusionsAlthough ARDS management improved over the last decades, the 90 day mortality remained high and stable over time for both ARDS patients with (57%) and without cirrhosis (41%). Nevertheless, the severity of patients without cirrhosis has increased over time, while the severity of patients with cirrhosis has remained stable.
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