Menaldi Rasmin1, Mia Elhidsi1, Prasenohadi1, Wiendo Syah Putra Yahya1, Yusup Subagio Sutanto2, Ana Rima Setijadi2, Ngakan Putu Parsama Putra3, Ungky agus Setyawan3, Oea Khairsyaf4, Russilawati4, Deddy Herman5, Mulyadi6, Teuku Zulfikar7, Dewi Behtri Yanifitri7
1 Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Persahabatan Hospital, Universitas Indonesia, Jakarta, Indonesia
2 Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Dr. Moewardi Hospital, Universitas Negeri Sebelas Maret, Solo, Indonesia
3 Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Dr. Saiful Anwar Hospital, Universitas Brawijaya, Malang, Indonesia
4 Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Dr. M. Djamil Hospital, Universitas Andalas, Padang, Indonesia
5 Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Dr. Achmad Moechtar Hospital, Universitas Andalas, Padang, Indonesia
6 Faculty of Medicine, Universitas Nahdlatul Ulama, Surabaya, Indonesia
7 Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Dr. Zainoel Abidin Hospital, Universitas Syiah Kuala, Aceh, Indonesia
DOI:10.4103/jnsbm.JNSBM_127_20
ABSTRACT
Background: Epidemiologic data of acute respiratory failure (ARF) are limited. This study aims to investigate the underlying diseases and in-hospital mortality of patients with ARF in Indonesia. Materials and Methods: An observational prospective cohort study involving patients with ARF in six hospitals was conducted. Data were collected between January and December 2017. Data on the type of ARF, quick sepsis-related organ failure assessment (qSOFA) score, underlying diseases, and in-hospital mortality were documented. Proportions were compared using Chi-square or Fisher exact tests. Multivariable regression models with variable selection based on a stepwise backward elimination were run to analyze the risk factors for in-hospital mortality. Results: A total of 412 patients (median age: 56-years-old) were included. Most of the subjects were male (66.9%), hypoxemic (55.3%), and acute onset (86.4%). The most commonly encountered underlying diseases were pneumonia (58.7%), chronic obstructive pulmonary disease (25.5%), lung tuberculosis (25.2%), lung cancer (16.5%), noncystic fibrosis bronchiectasis (11.9%), congestive heart failure (10.2%), and chronic kidney disease (CKD) (3.2%). There were 65% of patients received only oxygen therapy, invasive mechanical ventilation was utilized for 30.8% of patients, and 4.1% of patients underwent noninvasive mechanical ventilation. There were 201 (48.79%) in-hospital mortality cases. The risk factors of in-hospital mortality were qSOFA ≥2 (odds ratio [OR]: 2.420, 95% confidence interval [CI] 1.599–3.662; P = 0.000) and CKD (OR: 3.871, 95% CI 1.024–14.631; P = 0.046). Conclusions: Most of the underlying diseases of ARF in Indonesia are communicable diseases. Patients with qSOFA ≥2 and CKD have a higher risk of death during hospitalit.
Keywords: Acute respiratory failure, diseases, in-hospital mortality
