Predictors of diffuse alveolar damage in patients with acute respiratory distress syndrome: a retrospective analysis of clinical autopsies

Table 2 Predictors of diffuse alveolar damage in patients with clinical criteria for acute respiratory distress syndrome

	Bivariate test, OR (95% CI), p value	Multivariate logistic regression, OR (95% CI), p value
Characteristics of the patients
Female sex, n (%)	1.79 (1.15–2.78), p < 0.01	Not significant
Pneumonia, n (%)	1.54 (0.99–2.39), p = 0.05	Not significant
Duration of evolution of ARDS
> 72 h	3.92 (2.43–6.37), p < 0.001	3.29 (1.95–5.55), p < 0.001
Severity of hypoxemia	<0.0001
Mild ARDS (n = 49)	Reference
Moderate ARDS (n = 141)	4.72 (1.88–11.8), p < 0.001	3.92 (1.48–10.3), p = 0.006
Severe ARDS (n = 166)	10.1 (4.06–24.9), p < 0.001	6.18 (2.34–16.3), p < 0.001
Ancillary variables of severity
PEEP ≥ 10 cmH₂O	2.33 (1.51–3.59), p < 0.001	Not significant
Dynamic compliance < 40 ml/cmH₂O	5.12 (1.73–15.1), p < 0.01	Not significant
VE corrected PaCO₂ ≥ 10 L/minute	2.34 (1.40–3.93), p < 0.01	Not significant
PaCO₂ > 45 mmHg	1.73 (1.14–2.65), p = 0.01	Not significant
Dynamic driving pressure (peak − PEEP), cmH₂O	1.06 (1.04–1.09), p < 0.001	1.06 (1.04–1.09), p = 0.007
Extent of infiltrates on chest radiograph	<0.0001
Two quadrants	Reference
Three quadrants	2.45 (1.26–4.76), p < 0.01	1.63 (0.79–3.39), p = 0.19
Four quadrants	5.43 (2.93–10.1), p < 0.0001	2.91 (1.47–5.75), p = 0.002

Abbreviations: ARDS Acute respiratory distress syndrome, DAD Diffuse alveolar damage, PEEP Positive end-expiratory pressure, VE Minute ventilation; PaCO₂, Partial pressure of arterial carbon dioxide
All variables nonredundant associated with DAD with a p value < 0.15 were included in the maximal model, including severity score, sex, pneumonia as a risk factor for ARDS, duration of ARDS evolution > 72 h, severity of hypoxemia (mild, moderate, or severe using mild as the reference), PEEP ≥ 10 cmH₂O, dynamic compliance of the respiratory system < 40 ml/cmH₂O, expired minute volume corrected by PaCO₂ ≥ 10 L/minute, hypercapnia defined as PaCO₂ > 45 mmHg, dynamic driving pressure defined as peak pressure minus PEEP, and the extent of radiological infiltrates (two, three, or four quadrants using two quadrants as the reference)
Bold data are variables that remained significanltly associated with DAD after multivariate logistic regression

ISSN: 1364-8535