Driving pressure (DP) is a marker of severity of lung injury in patients with acute respiratory distress syndrome (ARDS) and has a strong association with outcome.

However, it is uncertain whether limiting DP can reduce the mortality of patients with acute hypoxemic respiratory failure (AHRF).

Therefore, this study aimed to determine the correlation between the initial DP setting and the clinical outcomes of patients with AHRF upon their initial admission to the intensive care unit (ICU).

The Medical Information Mart for Intensive Care IV (MIMIC-IV) database was used to search the data of patients with AHRF, with 180-day mortality representing the primary outcome.

Multiple regression analysis was subsequently performed to evaluate the initial DP and 180-day mortality association.

The reliability of the results was validated using restricted cubic splines and interaction studies.

This study retrospectively analyzed data from 907 patients—581 (64.06%) in the survival group and 326 (35.94%) in the nonsurvival group (NSG)—who were followed up 180 days after admission.

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