Prevalence, Outcomes and Healthcare Costs of Postoperative ARDS Compared with Medical ARDS

Bardají-Carrillo, Miguel; López-Herrero, Rocío; Espinoza-Fernández, Mario S.; Alonso-Villalobos, Lucía; Cobo-Zubia, Rosa; Prieto-Utrera, Rosa; Arroyo-Hernantes, Irene; Gómez-Sánchez, Esther; Camporota, Luigi; Villar, Jesús; Tamayo, Eduardo

doi:10.3390/jcm14145125

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Prevalence, Outcomes and Healthcare Costs of Postoperative ARDS Compared with Medical ARDS

by

Miguel Bardají-Carrillo

^1,2,3

,

Rocío López-Herrero

^1,2,3,4,*

,

Mario S. Espinoza-Fernández

^1,2,3,

Lucía Alonso-Villalobos

^1,2,3,

Rosa Cobo-Zubia

¹,

Rosa Prieto-Utrera

¹,

Irene Arroyo-Hernantes

^1,5,

Esther Gómez-Sánchez

^1,2,3,4,

Luigi Camporota

^6,7,†,

Jesús Villar

^{8,9,10,11,†}

and

Eduardo Tamayo

^1,2,3,4,†

¹

BioCritic, Group for Biomedical Research in Critical Care Medicine, 47003 Valladolid, Spain

²

Anesthesiology and Critical Care, Clinical University Hospital of Valladolid, 47003 Valladolid, Spain

³

Department of Surgery, University of Valladolid, 47003 Valladolid, Spain

⁴

CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Avenida Monforte de Lemos 5, 28029 Madrid, Spain

⁵

Department of Research and Innovation, Clinical University Hospital of Valladolid (HCUV), SACYL/IECSCYL, 47003 Valladolid, Spain

⁶

Department of Adult Critical Care, Guy’s and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London SE1 7EH, UK

⁷

Centre for Human and Applied Physiological Sciences, King’s College London Strand, London WC2R 2LS, UK

⁸

CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Avenida Monforte de Lemos 5, 28029 Madrid, Spain

⁹

Research Unit, Hospital Universitario Dr. Negrín, Fundación Canaria Instituto de Investigación Sanitaria de Canarias, Barranco de la Ballena s/n, 35019 Las Palmas de Gran Canaria, Spain

¹⁰

Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria St, Toronto, ON M5B 1T8, Canada

¹¹

Faculty of Health Sciences, Universidad del Atlántico Medio, Carretera de Quilmes 37, Tafira Baja, 35017 Las Palmas, Spain

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^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally as senior authors.

J. Clin. Med. 2025, 14(14), 5125; https://doi.org/10.3390/jcm14145125

Submission received: 28 May 2025 / Revised: 13 July 2025 / Accepted: 15 July 2025 / Published: 18 July 2025

(This article belongs to the Section Anesthesiology)

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Abstract

Background/Objectives: Postoperative acute respiratory distress syndrome (ARDS) is a recognized complication with reported prevalence rates of up to 20% and highly variable mortality. However, there is limited published evidence comparing the outcomes of postoperative ARDS with those of medical ARDS. We aimed to evaluate the prevalence, hospital mortality, and healthcare costs of postoperative ARDS in Spain between 2000 and 2022 and to compare them with those of medical ARDS. Methods: We performed a nationwide, registry-based study of all hospitalizations for postoperative ARDS in Spain between 1 January 2000 and 31 December 2022 using the Minimum Basic Data Set (MBDS) Registry. Results: We identified a total of 93,192 ARDS patients, of which 40,601 had postoperative ARDS. The postoperative ARDS prevalence varied between 0.05 and 0.22%, accounting for 45–50% of total ARDS cases recorded during the study period. Hospital mortality was lower in postoperative ARDS compared with medical ARDS during the first phase (2000–2015) (47.0% vs. 49.9%, p < 0.001) and converged during the second phase (2017–2022) (42.7% vs. 43.2%, p = 0.413). Postoperative ARDS was associated with a longer hospital stay and 1.5 times higher healthcare costs compared with medical ARDS. During the COVID-19 pandemic, mortality rates declined but costs peaked in both groups. The incidence of digestive tract infection was higher in postoperative ARDS. Conclusions: The prevalence of postoperative ARDS remained stable, except during the COVID-19 pandemic, and its hospital mortality declined and equalized with that of medical ARDS. However, the costs associated with postoperative ARDS remained significantly higher.

Keywords: acute respiratory distress syndrome; ARDS; postoperative ARDS; prevalence; mortality; healthcare cost

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MDPI and ACS Style

Bardají-Carrillo, M.; López-Herrero, R.; Espinoza-Fernández, M.S.; Alonso-Villalobos, L.; Cobo-Zubia, R.; Prieto-Utrera, R.; Arroyo-Hernantes, I.; Gómez-Sánchez, E.; Camporota, L.; Villar, J.; et al. Prevalence, Outcomes and Healthcare Costs of Postoperative ARDS Compared with Medical ARDS. J. Clin. Med. 2025, 14, 5125. https://doi.org/10.3390/jcm14145125

AMA Style

Bardají-Carrillo M, López-Herrero R, Espinoza-Fernández MS, Alonso-Villalobos L, Cobo-Zubia R, Prieto-Utrera R, Arroyo-Hernantes I, Gómez-Sánchez E, Camporota L, Villar J, et al. Prevalence, Outcomes and Healthcare Costs of Postoperative ARDS Compared with Medical ARDS. Journal of Clinical Medicine. 2025; 14(14):5125. https://doi.org/10.3390/jcm14145125

Chicago/Turabian Style

Bardají-Carrillo, Miguel, Rocío López-Herrero, Mario S. Espinoza-Fernández, Lucía Alonso-Villalobos, Rosa Cobo-Zubia, Rosa Prieto-Utrera, Irene Arroyo-Hernantes, Esther Gómez-Sánchez, Luigi Camporota, Jesús Villar, and et al. 2025. "Prevalence, Outcomes and Healthcare Costs of Postoperative ARDS Compared with Medical ARDS" Journal of Clinical Medicine 14, no. 14: 5125. https://doi.org/10.3390/jcm14145125

APA Style

Bardají-Carrillo, M., López-Herrero, R., Espinoza-Fernández, M. S., Alonso-Villalobos, L., Cobo-Zubia, R., Prieto-Utrera, R., Arroyo-Hernantes, I., Gómez-Sánchez, E., Camporota, L., Villar, J., & Tamayo, E. (2025). Prevalence, Outcomes and Healthcare Costs of Postoperative ARDS Compared with Medical ARDS. Journal of Clinical Medicine, 14(14), 5125. https://doi.org/10.3390/jcm14145125

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Prevalence, Outcomes and Healthcare Costs of Postoperative ARDS Compared with Medical ARDS

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