INCIDENCE, SEVERITY, AND MORTALITY OF ACUTE RESPIRATORY-FAILURE IN BERLIN, GERMANY

A prospective multicenter study was carried out from October 1 to Nove mber 30, 1991, to determine the incidence, severity, and mortality of acute respiratory failure (ARF) in Berlin, Germany, a metropolis with a population of 3.44 million. Adult patients from 72 intensive care un its (ICUs) were evaluated. ARF was defined as: (1) intubation and mech anical ventilation (I + MV) greater than or equal to 24 h; (2) age gre ater than or equal to 14 yr. Incidence of ARF was assessed as the numb er of patients fulfilling ARF criteria within the 2-mo study period. S everity of ARF was defined as ''no lung injury'' (NLI), ''mild-to-mode rate lung injury'' (MMLI), and ''severe lung injury'' (SLI) according to Murray and coworkers' proposals. Mortality was assessed as number o f patients with ARF dying during ICU stay. During the study period, 50 8 patients were diagnosed as having ARF, representing an incidence of ARF of 88.6 per 100,000/yr. Twenty-four h after I + MV, MMLI occurred in 94% and SLI in 3.6% of the ARF patients. Overall mortality rate was 42.7%. Mortality rate in the NLI group was 36.4%; in patients with MM LI, 40.8%; and in patients with SLI, 58.8%. Our data offer novel infor mation on incidence, severity, and mortality of ARF in a major urban p opulation.