Demographic, Ethiologic and Pulmonary Histopathological Findings in Patients with Acute Respiratory Failure: An Autopsy Study
ADP Ruppert, AM Soeiro, VL Capelozzi. University of São Paulo Medical School, São Paulo, Brazil
Background: Acute respiratory failure (ARF) has been one of the most important causes of death in intensive care units. Until this moment few studies have showed data about causes of death and certain aspects of pulmonary pathology observed in autopsies of patients with ARF are still unknown. This study considers 4,218 autopsies of patients who died of ARF and describes the demographic data, ethiology, and histological pulmonary findings.
Design: From 1,990 to 2,005, 24,336 pathological reports were reviewed. From these reports were selected 4,218 autopsies (17.33%) from patients age older than 1 year with ARF as cause of death. The following data were obtained: age, sex, and major associated diseases (found at the autopsy). Pulmonary histopathology was categorized as: diffuse alveolar damage (DAD); pulmonary edema (PE); alveolar hemorrhage (AH); and acute interstitial pneumonia (AIP).
Results: The age of the patients ranged from 1 to 99 years (median 51). Three hundred fifthy seven (357) (8.46%) patients were between 1 and 20 years old, 1,712 (40.59%) between 21 and 50 years old and 2,150 (50.97%) older than 50 years. Patients were male in 2,448 (58.04%) and female in 1,770 (41.96%) of the cases. DAD was present in 1,807 (42.84%), PE in 972 (23.04%), AH in 425 (10.08%) and AIP in 194 (4.60%) necropsies. The principal underlying diseases were bronchopneumonia in 1,079 (25.58%) patients, Acquired Immunodeficiency Syndrome in 1,047 (24.82%), sepsis in 508 (12.04%), liver cirrhosis in 494 (11.71%), cancer in 463 (10.98%), pulmonary thromboembolism in 339 (8.04%), acute myocardial infarct in 201 (4.77%), brain stroke in 188 (4.46%), tuberculosis in 156 (3.70%), chronic kidney failure in 100 (2.37%) and leukemia in 53 (1.26%) patients.
Conclusions: ARF has showed as an important cause of death, present in about 17% of autopsies. This report is the first autopsy study to include demographic data, ethiologic diagnosis, and respective histopathological findings in patients with ARF. Further studies are necessary to elucidate the complete pulmonary physiopathological mechanism involved with each associated disease.
Wednesday, March 24, 2010 9:30 AM
Poster Session V # 9, Wednesday Morning