The following is a summary of the “Mortality Due to Acute Respiratory Distress Syndrome in Latin America,” published in the April 2024 issue of Critical Care by Cruz et al.
Given the limited data available from this region compared to high-income countries, researchers started a prospective study evaluating mortality rates from acute respiratory distress syndrome (ARDS) in Latin America.
They searched multiple databases, including PubMed, Cochrane Central Register of Controlled Trials, Web of Science, and Latin American and Caribbean Health Science Literature (1967 to March 2023). Three pairs of independent reviewers assessed study eligibility based on titles and abstracts. Meta-analysis of proportions was carried out using a random-effects model. Sensitivity analyses were conducted, encompassing studies with low bias risk and those using the Berlin definition for diagnosis. Subgroup analysis compared various study designs, publication periods, and diagnostic criteria variations. Following this, meta-regression analyses were performed. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation framework.
The results showed 3,315 articles were identified, and 32 were included (involving 3,627 patients). Mortality stood at 52% in the pooled group (with low certainty of evidence). In the sensitivity analysis (based on the Berlin definition), mortality was recorded at 46% (with moderate certainty of evidence). Subgroup analysis revealed mortality rates of 53% (in randomized controlled trials), 51% (in observational studies), 66% (in studies published up to 2000), 50% (in studies published after 2000), 44% (in studies with Pao2/Fio2 ≤ 200), 56% (in studies from Argentina/Brazil), and 40% (in studies from other countries). Meta-regression analysis found no variables associated with mortality.
Investigators concluded that ARDS mortality remained high in Latin America compared to other regions, highlighting the need for action plans to improve patient outcomes.
Source: journals.lww.com/ccmjournal/abstract/9900/mortality_due_to_acute_respiratory_distress.328.aspx