The following is a summary of “Relationship Between Metabolic Syndrome and Mortality Among Patients With Acute Respiratory Distress Syndrome in Acute Respiratory Distress Syndrome Network and Prevention and Early Treatment of Acute Lung Injury Network Trials,” published in the March 2024 issue of Critical Care by Tea et al.
Researchers started a retrospective study to investigate the link between metabolic syndrome and mortality in patients enrolled in acute respiratory distress syndrome (ARDS) trials, excluding those with COVID-19.
They conducted an ancillary analysis utilizing data from seven randomized trials in the Biologic Specimen and Data Repository Information Coordinating Center database, which were part of the ARDS network and prevention and early treatment of acute lung injury network. Hospitalized patients having ARDS and metabolic syndrome (characterized by obesity, diabetes, and hypertension) were juxtaposed with comparable patients lacking metabolic syndrome (individuals meeting less than three criteria).
The result showed 28-day mortality was the primary outcome with 4,288 ARDS trial participants, 454 individuals (10.6%) with metabolic syndrome were compared to 3,834 controls (89.4%). The metabolic syndrome group had lower 28-day and 90-day mortality rates compared to the control group (aOR for 28-day: 0.70 [95% CI, 0.55–0.89] and for 90-day: 0.75 [95% CI, 0.60–0.95]). Each additional metabolic criterion from 0 to 3 reduced adjusted 28-day mortality by 18%, 22%, and 40%, respectively. In subgroup analyses based on ARDS causes, metabolic syndrome showed lower mortality than controls in cases of sepsis or pneumonia-induced ARDS (aOR at 28 days: 0.64 [95% CI, 0.48–0.84] and at 90 days: aOR 0.69 [95% CI, 0.53–0.89]), but not in noninfectious ARDS cases (aOR at 28 days: 1.18 [95% CI, 0.70–1.99] and at 90 days: aOR 1.26 [95% CI, 0.77–2.06]). The interaction P-values were 0.04 for the comparison on day 28 and 0.02 on day 90.
They concluded that in non-COVID-19 ARDS patients, having metabolic syndrome was linked to a lower risk of death, suggesting a potential avenue for future research in personalized medicine.
