Clinicoetiological Profile of Acute Respiratory Distress Syndrome and Its Association With the Sequential Organ Failure Assessment Score and Clinical Outcomes in a Tertiary Care ICU in Central India: A Prospective Observational Cohort Study.

BACKGROUND

Acute respiratory distress syndrome (ARDS) is a serious condition frequently encountered in intensive care units (ICUs) and is associated with high morbidity and mortality. Regional data are crucial for optimizing diagnosis and management, particularly in infection-prevalent regions like Central India.

OBJECTIVES

This study aimed to evaluate the clinicoetiological profile of ARDS patients and assess the prognostic value of Sequential Organ Failure Assessment (SOFA) scores at admission and 48 hours.

METHODS

This prospective observational cohort study included 100 adults who met the Berlin definition of ARDS and were admitted to a tertiary care ICU between January 2023 and January 2025. Demographic data, etiologies, comorbidities, arterial blood gas parameters, SOFA scores, ICU stay, and outcomes were analyzed, and p < 0.05 was considered significant.

RESULTS

The patient population consisted of individuals aged 20-80 years, with a mean age of 54.8 ± 12.3. Notably, 62% were male patients. Community-acquired pneumonia (25%) and sepsis (20%) were leading causes, followed by aspiration pneumonitis (17%). Common comorbidities included hypertension (28%), diabetes (22%), and chronic obstructive pulmonary disease (19%). At admission, patients were classified according to the Berlin Definition into mild, moderate, and severe ARDS based on the partial pressure of oxygen in arterial blood (PaO₂)/fraction of inspired oxygen (FiO₂) ratio. The mean ICU stay was 7.8 ± 4.2 days, and overall mortality was 60%. Significant associations were observed between ARDS severity and clinical outcome (p = 0.001); between SOFA scores at admission and at 48 hours and mortality (p < 0.0001); and between SOFA score and length of ICU stay (p < 0.0001). Mortality increased progressively with increasing ARDS severity and higher SOFA scores.

CONCLUSIONS

Infection-related ARDS, predominantly due to pneumonia and sepsis, was the major contributor to ICU mortality. Elevated SOFA scores and low PaO₂/FiO₂ ratios were strong predictors of poor outcome. Early recognition and serial organ dysfunction monitoring are essential to improve survival.