Relationship between Race and the Effect of Fluids on Long-term Mortality after Acute Respiratory Distress Syndrome. Secondary Analysis of the National Heart, Lung, and Blood Institute Fluid and Catheter Treatment Trial.
Rationale: Short-term follow-up in the Fluid and Catheter Treatment Trial (FACTT) suggested differential mortality by race with conservative fluid management, but no significant interaction.Objective: In a post hoc analysis of FACTT including 1-year follow-up, we sought to estimate long-term mortali...
| Publicado en: | Annals of the American Thoracic Society Vol. 14; no. 9; pp. 1443 - 1450 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | research randomized controlled trial Journal Article |
| Publicado: |
Oxford University Press / USA
Sep2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=124951332&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 124951332 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 23296933 FUCV jtl: Annals of the American Thoracic Society issn: 23296933 maglogo: N pubinfo: dt: Sep2017 vid: 14 iid: 9 pid: 622 pub: Oxford University Press / USA artinfo: ui: 124951332 124951332 NLM28708421 124951332 10.1513/AnnalsATS.201611-906OC NLM28708421 124951332 ppf: 1443 ppct: 7 formats: tig: atl: Relationship between Race and the Effect of Fluids on Long-term Mortality after Acute Respiratory Distress Syndrome. Secondary Analysis of the National Heart, Lung, and Blood Institute Fluid and Catheter Treatment Trial. aug: au: Jolley, Sarah E. Hough, Catherine L. Clermont, Gilles Hayden, Douglas Suqin Hou Schoenfeld, David Smith, Nicholas L. Thompson, Boyd Taylor Bernard, Gordon R. Angus, Derek C. Hou, Suqin affil: Louisiana State University, Section of Pulmonary/Critical Care Medicine, New Orleans, Louisiana. sug: subj: Fluid Therapy Respiratory Distress Syndrome, Acute Ethnology Respiratory Distress Syndrome, Acute Therapy Respiratory Distress Syndrome, Acute Mortality Male Time Factors Adult Female National Institutes of Health (U.S.) Aged Human United States Black Persons Length of Stay White Persons Probability Middle Age Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Funding Source Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Male Female ab: Rationale: Short-term follow-up in the Fluid and Catheter Treatment Trial (FACTT) suggested differential mortality by race with conservative fluid management, but no significant interaction.Objective: In a post hoc analysis of FACTT including 1-year follow-up, we sought to estimate long-term mortality by race and test for an interaction between fluids and race.Methods: We performed a post hoc analysis of FACTT and the Economic Analysis of Pulmonary Artery Catheters (EAPAC) study (which included 655 of the 1,000 FACTT patients with near-complete 1-year follow up). We fit a multistate Markov model to estimate 1-year mortality for all non-Hispanic black and white randomized FACTT subjects. The model estimated the distribution of time from randomization to hospital discharge or hospital death (available on all patients) and estimated the distribution of time from hospital discharge to death using data on patients after hospital discharge for patients in EAPAC. The 1-year mortality was found by combining these estimates.Results: Non-Hispanic black (n = 217, 25%) or white identified subjects (n = 641, 75%) were included. There was a significant interaction between race and fluid treatment (P = 0.012). One-year mortality was lower for black subjects assigned to conservative fluids (38 vs. 54%; mean mortality difference, 16%; 95% confidence interval, 2-30%; P = 0.027 between conservative and liberal). Conversely, 1-year mortality for white subjects was 35% versus 30% for conservative versus liberal arms (mean mortality difference, -4.8%; 95% confidence interval, -13% to 3%; P = 0.23).Conclusions: In our cohort, conservative fluid management may have improved 1-year mortality for non-Hispanic black patients with ARDS. However, we found no long-term benefit of conservative fluid management in white subjects. pubtype: Academic Journal doctype: research randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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