Fewer Post‑Traumatic ARDS Cases but Rising Mortality: A 2007–2019 NTDB Cohort Analysis

Highlights

– Between 2007 and 2019, ARDS incidence among mechanically ventilated adult trauma patients documented in the NTDB fell from ~22 to ~3 per 100 ventilated patients, but crude ARDS mortality increased (15.1% to 29.7%).

– After multivariable adjustment, ARDS independently predicted 30‑day in‑hospital mortality (OR 1.32; 95% CI, 1.27–1.37). Key patient-level correlates included severe sepsis, ventilator‑associated pneumonia (VAP), and acute kidney injury (AKI); plasma and platelet transfusion volumes were associated with ARDS in the transfused subset.