Supplemental Table E1. Adverse Event Definitions (10)
Adverse Event Name Definition
Accidental cut, puncture, perforation, or
hemorrhage
Accidental cut, puncture, perforation, or hemorrhage during Medical care during surgical operation
Infusion or transfusion
Kidney dialysis or other perfusion Injection or vaccination
Endoscopic examination Aspiration of fluid or tissue Failure of sterile
precautions
Documented failure of sterile precautions during Nonemergency procedures
Surgical operation Infusion or transfusion
Kidney dialysis and other perfusion Injection or vaccination
Endoscopic examination Aspiration of fluid or tissue Puncture
Catheterization
Retained foreign object Foreign object left in body during Surgical operation
Kidney dialysis or other perfusion Endoscopic examination Instrument or apparatus
failure
Mechanical failure of instrument or apparatus during Medical care during surgical operation
Infusion or transfusion
Supplemental Table 1 (continued)
Adverse Event Name Definition
Kidney dialysis or other perfusion Injection or vaccination
Endoscopic examination Aspiration of fluid or tissue Dosage failure Failure in dosage, including
Documented accidental overdose of drug or medicinal substance Excessive amount of blood or other fluid during transfusion or
infusion
Incorrect dilution of fluid during infusion
Inappropriate therapy (including nonadministration of necessary drug or medicinal substance)
Contaminated or infected blood, fluid, drug, or biological substance
Contaminated or infected blood, other fluid, drug, or biological substance, including the presence of
Bacterial pyrogens
Endotoxin-producing bacteria
Serum hepatitis–producing agent
Contaminated substance transfused or infused
Contaminated substance injected or used for vaccination
Contaminated drug or biological substance administered by other
means
Other and unspecified Other and unspecified misadventures during medical care, including Documented mismatched blood in transfusion
Wrong fluid in infusion
Failure in suture and ligature during surgical operation
Endotracheal tube wrongly placed during medical or surgical care Failure to introduce or remove other tube or instrument
Supplemental Table 2: Medications Tracked
Statins
Advicor (niacin XL/lovastatin) Caduet
(amlodipine/atorvastatin) Crestor (rosuvastatin) Lescol (Lescol XL) (fluvastatin)
Lipitor (atorvastatin) Mevacor, Altoprev (lovastatin)
Pravachol (pravastatin) Simcor (niacin
XL/simvastatin) Vytorin
(simvastatin/ezetimibe) Zocor (simvastatin) Insulin
Insulin IV Insulin SC
Antiplatelets Aspirin
Abciximab (ReoPro) Cilostazol
Clopidogrel (Plavix) Dipyridamole (Persantine) Eptifibatide (Integrilin) Ticlopidine (Ticlid) Narcotics
Codeine
Darvon (propoxyphene) Darvocet
(propoxyphene/acetaminophen) Fentanyl continuous infusion Fentanyl IV push/bolus Meperidine (Demerol) Morphine
Oxycodone Percocet
(oxycodone/acetaminophen) Percodan (oxycodone/aspirin)
Oxazepam Prazepam Quazepam Temazepam Propofol Furosemide Amiodarone Heparin IV Heparin SC
Lovenox (enoxaparin)
ACE inhibitors
Accupril (quinapril) Aceon (perindopril) Altace (ramipril) Capoten (captopril) Lotensin (benazepril) Mavik (trandolapril) Monopril (fosinopril) Prinivil, Zestril (lisinopril)
Univasc (moexipril) Vasotec (enalapril) Angiotensin receptor blockers
Candesartan Eprosartan Irbesartan Losartan Olmesartan Telmisartan Valsartan Corticosteroids
Roxicet
(oxycodone/acetaminophen) Tylox
(oxycodone/acetaminophen) Sedatives
Dexmedetomidine Methohexital Pentazocine Phenobarbital Promethazine Thiopental Trazodone
H2 Blockers/antacids Cimetidine (Tagamet) Famotidine (Pepcid) Nizatidine (Axid) Ranitidine (Zantac) PPIs/antacids
Esomeprazole (Nexium) Lansoprazole (Prevacid) Omeprazole (Prilosec) Pantoprazole (Protonix)
Betamethasone Dexamethasone Hydrocortisone Methylprednisolone Betamethasone Budesonide Cortisone Dexamethasone Prednisolone Prednisone Antioxidants
N-Acetylcysteine
Omega 3 Vitamin C Vitamin E Anticoagulation
Coumadin (warfarin) Fragmin (dalteparin)
Rabeprazole (Aciphex) Benzodiazepines
Alprazolam Chlordiazepoxide Clonazepam Clorazepate Diazepam Flunitrazepam Flurazepam Halazepam Lorazepam Midazolam Nitrazepam Nordazepam
Abbreviations: ACE, angiotensin-converting enzyme; IV, intravenous; PPI, proton pump inhibitor; SC, subcutaneous.
Supplemental Table 3: In-hospital Medication Administration in ARDS Cases and Controls
Group*
In-hospital Medication for ≥1 Dose
ARDS Cases (n=414)
Non-ARDS
Controls (n=414) OR (95% CI)** P Value
Antiplatelet agents 106 (25.6) 162 (39.1) 0.9 (0.8-0.9) .02
Statins 77 (18.6) 119 (28.7) 0.9 (0.8-1.0) .08
ACEIs and ARBs 62 (15.0) 100 (24.2) 0.9 (0.8-1.0) .17
Anticoagulants 253 (61.1) 266 (64.3) 1.1 (0.9-1.3) .07
PPIs and H2 blockers 282 (68.1) 255 (61.6) 1.1 (1.0-1.2) <.01
Amiodarone 25 (6.0) 17 (4.1) 1.1 (0.9-1.3) .31
Insulin 139 (33.6) 121 (29.2) 1.1 (1.0 -1.2) .04
Narcotics 332 (80.2) 289 (69.8) 1.1 (1.1-1.3) <.01
Sedatives 89 (21.5) 78 (18.8) 1.1 (0.9-1.3) .42
Antioxidants 23 (5.6) 18 (4.3) 1.2 (0.9-1.6) .25
Furosemide 170 (41.1) 113 (27.3) 1.1 (1.0-1.2) <.01
Benzodiazepine 259 (62.6) 176 (42.5) 1.6 (1.3-1.8) <.01
Abbreviations: ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker;
ARDS, acute respiratory distress syndrome; OR, odds ratio; PPI, proton-pump inhibitor.
*Values are No. of patients (%).
** Univariate (unadjusted) OR
Supplemental Table 4: The raw numbers of ARDS cases and selected hospital exposures corresponding to supplement figure1
Year ARDS Identified cases
ARDS Matched Cases
NG tube Inadequate antimicrobial
Adverse Events
2001 68 53 36 25 29
2002 68 46 24 13 21
2003 62 53 22 16 23
2004 63 57 21 14 23
2005 52 46 21 6 9
2006 40 40 19 10 17
2007 40 35 16 12 16
2008 34 26 7 8 6
2009 43 30 15 5 13
2010 38 28 9 10 12
Supplemental Figure 1: Generalized additive model (GAM) plots for time trends in acute respiratory distress syndrome (ARDS) cases and selected risk factors. The plots show the predicted proportion from the GAM fit (solid lines) and the 95% CIs (dashed lines). The null hypothesis for the P value is whether the trend is linear. All 3 risk factors shown have a significant nonlinear trend in the incidence of the risk factors, A- ARDS cases; B- Inadequate empirical antimicrobial therapy; C- medical and surgical adverse events; D- presence of nasogastric tube.
