CHEST Guidelines-Geo-economic-Variations-and-ARDS

Geo-economic-Variations-and-ARDS_chest

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The article discusses significant geo-economic variations in the epidemiology, care, and outcomes of Acute Respiratory Distress Syndrome (ARDS) as identified in a study by Laffey et al. published in Lancet Respiratory Medicine. The study used data from LUNG SAFE, a large observational study that tracked severe acute respiratory failure in 12,906 patients across 50 countries. It found that the period prevalence of ARDS is notably high, with a wide variation in the incidence of ARDS per ICU bed.<br /><br />Laffey et al.'s analysis of a subset of 2,813 ARDS patients revealed significant differences across three geo-economic regions: European high-income countries, other high-income countries, and middle-income countries. Importantly, no data from low-income country ICUs were included, and many of the patients were from academic medical centers. The study found an independent link between gross national income per person and mortality, which was not explained by ICU structure or staffing.<br /><br />Although ARDS was only recognized in 62% of patients, with best practices underutilized, middle-income countries demonstrated higher recognition rates (66%) compared to high-income, non-European countries (54%). The study underscores a persistent gap in evidence-based clinical care and questions how practices from middle-income countries could improve outcomes elsewhere.<br /><br />The editorial urges the need for broader scientific collaboration and diversity to address ARDS globally. This includes recognizing critical illness as a worldwide issue and addressing disparities in mortality affected by racial and ethnic differences. The authors emphasize the necessity of implementing existing knowledge into practice to genuinely impact clinical outcomes and mortality rates in ARDS patients. The exploration of geo-economic factors invites research that spans genetics, epidemiology, economics, and social sciences, encouraging collaboration among specialists from various geographic locations.

Keywords

Acute Respiratory Distress Syndrome

geo-economic variations

epidemiology

LUNG SAFE study

ICU bed incidence

mortality disparities

evidence-based care

scientific collaboration

global health

racial and ethnic differences