D-dimer is a fibrin degradation product formed during fibrinolysis, the process of breaking down a blood/fibrin clot. Our study showed that D-dimer was an independent predictor of ARDS development and mortality. Hyperglycemia is known to have a proinflammatory effect, and may be correlated with poor outcome in hospitalized/critically ill patients. Consistent with this correlation, odds ratio analysis after ARDS development identified DM as a risk factor. To further understand the accurate levels of the predictors for predicting ARDS, we used stratified analysis for each index. Positive likelihood ratio was included in the study due to a combination of sensitivity and specificity to reflect the reality of the indicators. ALT (>70-100U/L), AST (> 94U/L), D-dimer (>1.6mg/L), hemoglobin (<90g/ L), and albumin (<25g/L) at the time of admission were independent predictors for ARDS development in the setting of miliary TB. Simple miliary TB can damage organs, inducing mild increases in ALT and AST, although these incremental changes are too small to have any accuracy in predicting the occurrence of ARDS. However, when one develops ARDS, inflammatory mediators will seriously damage the organs, resulting in significantly higher increases in the indexes than those in simple miliary TB, which may translate into higher accuracy for predicting ARDS. Though ESR was significantly elevated in miliary TB, it did not reach statistical significance in association with ARDS. Our findings suggested that ESR has minimal value in predicting ARDS.