Abstract
Background
Acute Respiratory Distress Syndrome (ARDS) is a critical complication of sepsis, associated with high morbidity and mortality. Identifying risk factors for ARDS among sepsis patients is essential for early intervention and improving outcomes.
Methods
We conducted a comprehensive meta-analysis, reviewing studies that examined the association between various risk factors and ARDS development in sepsis patients. Databases such as PubMed, EMBASE, Cochrane Library, Medline, CINAHL, and Web of Science were searched up to January 2024, without language restrictions. Eligible studies included observational cohorts and case-control studies. Pooled odds ratios (ORs) and standardized mean differences (SMDs) were calculated using a random-effects model. Heterogeneity was assessed through I² statistics, and publication bias was evaluated via the Luis Furuya-Kanamori (LFK) index.
Results
15 studies with more than 40,000 participants were analyzed. Significant risk factors for ARDS included pulmonary infection (OR: 2.696, 95% CI: 1.655 to 4.390), septic shock (OR: 2.627, 95% CI: 1.850 to 3.731), and pancreatitis (OR: 3.734, 95% CI: 2.958 to 4.712). No significant associations were found for sex (OR: 1.106, 95% CI: 0.957 to 1.279), smoking status (OR: 1.214, 95% CI: 0.835 to 1.765), or steroid use (OR: 0.901, 95% CI: 0.617 to 1.314). APACHE-II and SOFA scores were predictive of ARDS development, emphasizing their utility in clinical assessments.
Conclusion
Pulmonary infection, septic shock, and pancreatitis significantly increase ARDS risk in sepsis patients. Our findings advocate for targeted management of these risk factors to mitigate ARDS development, emphasizing the importance of personalized care in sepsis management.