Clinicoetiological Profile of Acute Respiratory Distress Syndrome and Its Association With the Sequential Organ Failure Assessment Score and Clinical Outcomes in a Tertiary Care ICU in Central India: A Prospective Observational Cohort Study

Background: Acute respiratory distress syndrome (ARDS) is a serious condition frequently encountered in intensive care units (ICUs) and is associated with high morbidity and mortality. Regional data are crucial for optimizing diagnosis and management, particularly in infection-prevalent regions like Central India. Objectives: This study aimed to evaluate the clinicoetiological profile of ARDS patients and assess the prognostic value of Sequential Organ Failure Assessment (SOFA) scores at admission and 48 hours. Methods: This prospective observational cohort study included 100 adults who met the Berlin definition of ARDS and were admitted to a tertiary care ICU between January 2023 and January 2025. Demographic data, etiologies, comorbidities, arterial blood gas parameters, SOFA scores, ICU stay, and outcomes were analyzed, and p < 0.05 was considered significant. Results: The patient population consisted of individuals aged 20-80 years, with a mean age of 54.8 ± 12.3. Notably, 62% were male patients. Community-acquired pneumonia (25%) and sepsis (20%) were leading causes, followed by aspiration pneumonitis (17%). Common comorbidities included hypertension (28%), diabetes (22%), and chronic obstructive pulmonary disease (19%). At admission, patients were classified according to the Berlin Definition into mild, moderate, and severe ARDS based on the partial pressure of oxygen in arterial blood (PaO₂)/fraction of inspired oxygen (FiO₂) ratio. The mean ICU stay was 7.8 ± 4.2 days, and overall mortality was 60%. Significant associations were observed between ARDS severity and clinical outcome (p = 0.001); between SOFA scores at admission and at 48 hours and mortality (p < 0.0001); and between SOFA score and length of ICU stay (p < 0.0001). Mortality increased progressively with increasing ARDS severity and higher SOFA scores. Conclusions: Infection-related ARDS, predominantly due to pneumonia and sepsis, was the major contributor to ICU mortality. Elevated SOFA scores and low PaO₂/FiO₂ ratios were strong predictors of poor outcome. Early recognition and serial organ dysfunction monitoring are essential to improve survival.