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Original Article
- Epidemiology
- Trends and management of acute respiratory failure in hospitalized patients: a multicenter retrospective study in South Korea
- Won Jin Yang, Yong Jun Choi, Kyung Soo Chung, Ji Soo Choi, Bo Mi Jung, Jae Hwa Cho
- Acute Crit Care. 2025;40(2):171-185. Published online May 28, 2025
- DOI: https://doi.org/10.4266/acc.004728
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- 233 Download
- 3 Web of Science
- 3 Crossref
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Abstract
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Supplementary Material - 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. -
Citations
Citations to this article as recorded by
- Assessing respiratory muscle effort during noninvasive respiratory support in acute hypoxemic respiratory failure: A State-of-the Art Review from physiology to bedside
Brigitta Fazzini, Roberto Tonelli, Rik Gosselink, Alberto Lucchini, Alessandro Galazzi, Ema Swingwood, Dani Marti, Emanuele Rezoagli, Frederique Paulus, Marcus J. Schultz, Patricia R.M. Rocco, Denise Battaglini
Intensive and Critical Care Nursing.2026; 97: 104490. CrossRef - Integrated cardiopulmonary ultrasound in diagnosing acute respiratory failure in critically Ill patients
Asmaa Saad Abu-Elkheir, Hany Hussein Moussa, Mohamed Ali Hammad, Mohamed Mokhtar Eid, Shymaa Abd Elgawad Saad, Walaa M. Eid
The Egyptian Journal of Bronchology.2026;[Epub] CrossRef - The predictive value of malnutrition on the prognosis of severe respiratory failure in elderly patients: a multicenter retrospective study based on interpretable machine learning
Xi Wang, Shipeng Ma, Henglu Wang
Frontiers in Nutrition.2026;[Epub] CrossRef
- Assessing respiratory muscle effort during noninvasive respiratory support in acute hypoxemic respiratory failure: A State-of-the Art Review from physiology to bedside
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