Trends and management of acute respiratory failure in hospitalized patients: a multicenter retrospective study in South Korea
Background Acute respiratory failure (ARF) is the leading cause of hospitalization and is associated with in-hospital mortality. This study aimed to elucidate the epidemiology and clinical outcomes of ARF. Methods We retrospectively screened patients admitted to three hospitals in South Korea betwee...
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Korean Society of Critical Care Medicine
2025-05-01
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| Series: | Acute and Critical Care |
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| Online Access: | http://accjournal.org/upload/pdf/acc-004728.pdf |
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| author | Won Jin Yang Yong Jun Choi Kyung Soo Chung Ji Soo Choi Bo Mi Jung Jae Hwa Cho |
| author_facet | Won Jin Yang Yong Jun Choi Kyung Soo Chung Ji Soo Choi Bo Mi Jung Jae Hwa Cho |
| author_sort | Won Jin Yang |
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| description | Background Acute respiratory failure (ARF) is the leading cause of hospitalization and is associated with in-hospital mortality. This study aimed to elucidate the epidemiology and clinical outcomes of ARF. Methods We retrospectively screened patients admitted to three hospitals in South Korea between January 2018 and December 2022. We included individuals aged 18 years, diagnosed with either type 1 ARF (arterial oxygen partial pressure [PaO2] <60 mm Hg) or type 2 ARF (arterial carbon dioxide partial pressure (PaCO2) >45 mm Hg) with a pH of <7.35, or diagnosed with the combined-type ARF. Results Among the 768,700 hospitalized patients, 33,278 (4.3%) developed ARF. The most common cause of ARF was sepsis (15,757 patients, 47.3%), and the most frequent comorbidity was malignancy (15,403 patients, 43.6%). Among ARF patients, 15,671 (47.1%) required intensive care unit transfer, while 8,980 (27.0%) experienced in-hospital mortality. Over 5 years, the proportion of ARF patients aged 80 years and older has shown a consistent annual increase (coefficient, 0.085 and Ptrend <0.001). Concurrently, the in-hospital mortality rate exhibited an upward trend, increasing from 25.5% in 2018 to 29.3% in 2022 (coefficient, 1.017 and Ptrend<0.001). Among the respiratory support methods used for patients with ARF over the 5-year period, high-flow nasal cannula usage steadily increased (coefficient, 4.137 and Ptrend<0.001), whereas the use of invasive mechanical ventilation declined (coefficient, –0.983 and Ptrend<0.001). Conclusions ARF frequency and in-hospital mortality rates are increasing, driven by various etiologies. Despite these trends, research on the epidemiology and individualized treatments for older patients is limited, highlighting the need for nationwide prospective multicenter studies. |
| format | Article |
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| issn | 2586-6052 2586-6060 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Korean Society of Critical Care Medicine |
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| series | Acute and Critical Care |
| spelling | doaj-art-dc51261a74504641bcfdcfd94f11c7fa2025-08-20T02:10:07ZengKorean Society of Critical Care MedicineAcute and Critical Care2586-60522586-60602025-05-0140217118510.4266/acc.0047281607Trends and management of acute respiratory failure in hospitalized patients: a multicenter retrospective study in South KoreaWon Jin Yang0Yong Jun Choi1Kyung Soo Chung2Ji Soo Choi3Bo Mi Jung4Jae Hwa Cho5 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, KoreaBackground Acute respiratory failure (ARF) is the leading cause of hospitalization and is associated with in-hospital mortality. This study aimed to elucidate the epidemiology and clinical outcomes of ARF. Methods We retrospectively screened patients admitted to three hospitals in South Korea between January 2018 and December 2022. We included individuals aged 18 years, diagnosed with either type 1 ARF (arterial oxygen partial pressure [PaO2] <60 mm Hg) or type 2 ARF (arterial carbon dioxide partial pressure (PaCO2) >45 mm Hg) with a pH of <7.35, or diagnosed with the combined-type ARF. Results Among the 768,700 hospitalized patients, 33,278 (4.3%) developed ARF. The most common cause of ARF was sepsis (15,757 patients, 47.3%), and the most frequent comorbidity was malignancy (15,403 patients, 43.6%). Among ARF patients, 15,671 (47.1%) required intensive care unit transfer, while 8,980 (27.0%) experienced in-hospital mortality. Over 5 years, the proportion of ARF patients aged 80 years and older has shown a consistent annual increase (coefficient, 0.085 and Ptrend <0.001). Concurrently, the in-hospital mortality rate exhibited an upward trend, increasing from 25.5% in 2018 to 29.3% in 2022 (coefficient, 1.017 and Ptrend<0.001). Among the respiratory support methods used for patients with ARF over the 5-year period, high-flow nasal cannula usage steadily increased (coefficient, 4.137 and Ptrend<0.001), whereas the use of invasive mechanical ventilation declined (coefficient, –0.983 and Ptrend<0.001). Conclusions ARF frequency and in-hospital mortality rates are increasing, driven by various etiologies. Despite these trends, research on the epidemiology and individualized treatments for older patients is limited, highlighting the need for nationwide prospective multicenter studies.http://accjournal.org/upload/pdf/acc-004728.pdfepidemiologyintensive care unitskoreamortalityrespiratory failurerespiratory insufficiency |
| spellingShingle | Won Jin Yang Yong Jun Choi Kyung Soo Chung Ji Soo Choi Bo Mi Jung Jae Hwa Cho Trends and management of acute respiratory failure in hospitalized patients: a multicenter retrospective study in South Korea Acute and Critical Care epidemiology intensive care units korea mortality respiratory failure respiratory insufficiency |
| title | Trends and management of acute respiratory failure in hospitalized patients: a multicenter retrospective study in South Korea |
| title_full | Trends and management of acute respiratory failure in hospitalized patients: a multicenter retrospective study in South Korea |
| title_fullStr | Trends and management of acute respiratory failure in hospitalized patients: a multicenter retrospective study in South Korea |
| title_full_unstemmed | Trends and management of acute respiratory failure in hospitalized patients: a multicenter retrospective study in South Korea |
| title_short | Trends and management of acute respiratory failure in hospitalized patients: a multicenter retrospective study in South Korea |
| title_sort | trends and management of acute respiratory failure in hospitalized patients a multicenter retrospective study in south korea |
| topic | epidemiology intensive care units korea mortality respiratory failure respiratory insufficiency |
| url | http://accjournal.org/upload/pdf/acc-004728.pdf |
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