MỐI LIÊN QUAN GIỮA CHỈ SỐ BỆNH LÝ PHỐI HỢP CHARLSON VÀ TỬ VONG NGÀY THỨ 28 Ở BỆNH NHÂN MẮC HỘI CHỨNG SUY HÔ HẤP CẤP TIẾN TRIỂN

Abstract

Objective: To describe comorbidities and assess the association between the Charlson Comorbidity Index (CCI) and mortality prediction in patients with acute respiratory distress syndrome (ARDS). Methods: A retrospective descriptive study was conducted on 50 ARDS patients from June 2023 to May 2025. Inclusion criteria were: meeting the diagnostic standards for ARDS and age ≥18 years. Data were collected from medical records. Outcomes were analyzed based on the relationship between CCI score and patient prognosis. Results: The prevalence of comorbidities was 66%, most commonly mild chronic liver disease (27,3%), uncomplicated diabetes mellitus (24.2%), and connective tissue disease (21,2%), with a mean CCI score of 1.36 (range 0–5). Patients with comorbidities had a nearly threefold higher mortality risk compared with those without, although this difference was not statistically significant (p = 1.03). Multivariate regression analysis showed that higher CCI scores were associated with increased mortality risk in ARDS patients, but this did not reach statistical significance (OR: 2.20, p = 0.08). In contrast, higher SOFA scores at admission were independently associated with mortality (OR: 1.29; 95% CI: 1.03–1.61; p = 0.027). The mean age of non-survivors (55.9 ± 16.5 years) was significantly higher than that of survivors (41.6 ± 14.6 years; p = 0.012). The number of days using neuromuscular blockers tended to be higher in the non-survivor group but was not statistically significant (p = 0.106). Other factors, such as ECMO use (46.2% vs 27.3%), male sex (48.7% vs 72.7%), and renal replacement therapy (92.3% vs 72.7%), showed no significant differences (p>0.05). Conclusion: Our study demonstrates that comorbidities, organ dysfunction severity, and age influence mortality in ARDS patients. While the CCI did not prove to be a reliable predictor of mortality in ARDS, the SOFA score appears to be a more useful tool for prognostication in this patient population.