Medical planning for disaster response: Identifying risk factors for developing adult respiratory distress syndrome among trauma patients.

Introduction: Adult respiratory distress syndrome (ARDS) is a well-described complication of critical illness. We hypothesized that rates of comorbid diseases in a population may influence the risk for developing ARDS in trauma patients. This can help plan medical responses. Methods: Patients from the 2017 National Trauma Databank were analyzed. Inclusion criteria were an injury severity score (ISS) of ≥ 2 and 1 or more documented days of mechanical ventilation. Data were analyzed using χ 2, Student’s t test, Mann–Whitney U test, or logistic regression as indicated. Results: Diabetes (odds ratio [OR] 1.33, 95 percent confidence interval [CI] 1.17-1.52), smoking (OR 1.26, 95 percent CI 1.13-1.40), transfusion (OR 1.20, 95 percent CI 1.09-1.32), ISS (OR 1.02, 95 percent CI 1.02-1.03), male gender (OR 1.22, 95 percent CI 1.10-1.35), decreasing Glasgow coma score (OR 1.04, 95 percent CI 1.03-1.05), and increasing abbreviated injury score of the thorax (OR 1.12, 95 percent CI 1.09-1.16) were associated with an increase in risk for developing ARDS. Conclusion: Diabetes and smoking are risk factors for developing ARDS after trauma. Medical response planning in countries with high rates of diabetes mellitus or smoking should take into account a greater need for intensive care and longer patient admissions to field hospitals.