Quality of life after acute respiratory distress syndrome: a meta-analysis

Dowdy, David W.; Eid, Mark P.; Dennison, Cheryl R.; Mendez-Tellez, Pedro A.; Herridge, Margaret S.; Güallar, Eliseo; Pronovost, Peter J.; Needham, Dale M.

doi:10.1007/s00134-006-0217-3

Cited by 307 publications

(210 citation statements)

References 49 publications

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“…41 The most common scale used to measure the HRQOL of survivors of critical illness is the Medical Outcomes Study 36-Item Short Form Health Survey, Standard Form (SF-36). 42 This questionnaire consists of 36 items, which measure both physical health (physical function, physical role function, bodily pain, and general health) and mental health (vitality, social function, emotional function, and mental health).…”

Section: Health-related Quality Of Lifementioning

confidence: 99%

What's Next After ARDS: Long-Term Outcomes

et al. 2016

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SummaryARDS is a life-threatening organ failure due to several pulmonary and extrapulmonary injuries with an incidence between 5 and 60 cases/100,000 persons/y. Patients with ARDS have non-cardiogenic pulmonary edema and dyspnea often requiring invasive mechanical ventilation and intensive care admission. Although the short-term mortality rate has significantly decreased in the last decade, mainly due to the widespread application of lung-protective ventilation and better general support, long-term outcomes are still unsatisfactory. Besides simply evaluating the outcome at hospital discharge, several recent studies have assessed the health-related quality of life, neuropsychological disability, radiological findings, and pulmonary dysfunction up to 5 y. This paper reviews the literature regarding the long-term outcomes in patients with ARDS. Key words: ARDS; long-term outcomes; health-related quality of life; neuropsychological disability; pulmonary function; lung imaging. [Respir Care 2016;61(5):689 -699.

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Section: Health-related Quality Of Lifementioning

confidence: 99%

What's Next After ARDS: Long-Term Outcomes

et al. 2016

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“…Studies of critically ill patients hospitalized in the intensive care unit (ICU) for at least 7 days suggest that greater than one-fourth develop neuromuscular weakness attributable to the ICU stay (1)(2)(3)(4)(5)(6)(7)(8)(9). This disablement is associated with reductions in health-related quality of life, increased psychological distress, and delayed return to work (3)(4)(5)(6)(7)(8) with impairments persisting for years after the index hospitalization.…”

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confidence: 99%

Hospital-Level Factors Associated with Report of Physical Activity in Patients on Mechanical Ventilation across Washington State

Jolley

Dale²,

Hough

2015

Annals ATS

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Rationale: Use of physical and/or occupational therapy in the intensive care unit (ICU) is safe, feasible, and demonstrates improvements in functional status with early administration. Access to physical and/or occupational therapy in the ICU is variable, with little known regarding its use in community ICUs.Objectives: Determine what proportion of hospitals across Washington State report use of physical activity in mechanically ventilated patients and investigate process of care factors associated with reported activity delivery.Methods: Cross-sectional telephone interview survey study of nurse managers in hospitals caring for patients on mechanical ventilation across Washington State in 2013. Survey responses were linked with hospital-level data available in the Washington State Department of Health Comprehensive Hospital Abstract Reporting System database. Chi-square testing was used to explore unadjusted associations between potential process of care factors and report on activity delivery. Two multivariable logistic regression models were developed to explore the association between presence of a mobility protocol and report on delivery of activity. Measurements and Main Results:We identified 54 hospitals caring for patients on mechanical ventilation; 47 participated in the survey (response rate, 85.5%). Nurse managers from 36 (76.6%) hospitals reported use of physical activity in patients on mechanical ventilation, with 22 (46.8%) reporting use of high-level physical activity (transferring to chair, standing or ambulating) and 24 (51.1%) reporting use in high-severity patients (patients requiring mechanical ventilation and/or vasopressors). Presence of a written ICU activity protocol (odds ratio [OR], 5.54; 95% confidence interval [CI], 1.60-19.18; P = 0.006), hospital volume (OR, 5.33; 95% CI, 1.54-18.48; P = 0.008), and academic affiliation (OR, 4.40; 95% CI, 1.23-15.63; P = 0.02) were associated with report of higher level activity. Presence of a written ICU activity protocol (OR, 6.00; 95% CI, 1.69-21.14; P = 0.005) and academic affiliation (OR, 4.50; 95% CI, 1.21-16.46; P = 0.02) were associated with report of delivery of physical activity to high-severity patients.Conclusions: Nurse managers at three-fourths (76.6%) of eligible hospitals across Washington State reported use of physical activity in patients on mechanical ventilation. Hospital-level factors including hospital volume, academic affiliation, and presence of a mobility protocol were associated with report of higher level activity and delivery of activity to high-severity patients.Keywords: early mobilization; critical illness myopathy; physical therapy; intensive care unit-acquired weakness

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“…For example, survivors of acute respiratory distress syndrome (ARDS) have prolonged 6-minute walk times, executive dysfunction, other neuropsychiatric deficits, and diminished ability to return to work (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Numerous studies have found quality of life among survivors of critical illness (14,15), severe sepsis (16,17), and ARDS (4-8, 13, 18) to be abnormally low.…”

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confidence: 99%

Spurious Inferences about Long-Term Outcomes

Iwashyna

Netzer

Langa

et al. 2012

Am J Respir Crit Care Med

114

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Rationale: Survivors of critical illness suffer significant limitations and disabilities. Objectives: Ascertain whether severe sepsis is associated with increased risk of so-called geriatric conditions (injurious falls, low body mass index [BMI], incontinence, vision loss, hearing loss, and chronic pain) and whether this association is measured consistently across three different study designs. Methods: Patients with severe sepsis were identified in the Health and Retirement Study, a nationally representative cohort interviewed every 2 years, 1998 to 2006, and in linked Medicare claims. Three comparators were used to assess an association of severe sepsis with geriatric conditions in survivors: the prevalence in the United States population aged 65 years and older, survivors' own pre-sepsis levels assessed before hospitalization, or survivors' own pre-sepsis trajectory. Measurements and Main Results: Six hundred twenty-three severe sepsis hospitalizations were followed a median of 0.92 years. When compared with the 65 years and older population, surviving severe sepsis was associated with increased rates of low BMI, injurious falls, incontinence, and vision loss. Results were similar when comparing survivors to their own pre-sepsis levels. The association of low BMI and severe sepsis persisted when controlling for patients' pre-sepsis trajectories, but there was no association of severe sepsis with injurious falls, incontinence, vision loss, hearing loss, and chronic pain after such controls. Conclusions: Geriatric conditions are common after severe sepsis. However, severe sepsis is associated with increased rates of only a subset of geriatric conditions, not all. In studying outcomes after acute illness, failing to measure and control for both preillness levels and trajectories may result in erroneous conclusions.Keywords: severe sepsis; long-term outcomes; geriatric conditions; cohort studies; trajectory bias A substantial body of research has demonstrated that survivors of critical illness face extensive physical, psychological, cognitive, and social deficits in the aftermath of their critical illness (1). For example, survivors of acute respiratory distress syndrome (ARDS) have prolonged 6-minute walk times, executive dysfunction, other neuropsychiatric deficits, and diminished ability to return to work (2-13). Numerous studies have found quality of life among survivors of critical illness (14, 15), severe sepsis (16,17), and ARDS (4-8, 13, 18) to be abnormally low.Patients surviving critical illness have limitations and disabilities somewhat characteristic of an older adult population. Rubenfeld recently postulated a "progeric hypothesis" that the sequelae of critical illness mirror accelerated aging (19). This hypothesis suggests that severe sepsis may be associated with the development of so-called geriatric conditions (15,20,21). These are conditions common among older adults, multifactorial in etiology, and associated with disability, often contributing to decreased quality of life (20-23). The followin...

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Quality of life after acute respiratory distress syndrome: a meta-analysis

Abstract: ARDS survivors in different clinical settings experience similar decrements in QOL. The precise magnitude of these decrements helps clarify the long-term prognosis for ARDS survivors.

Cited by 307 publications

References 49 publications

What's Next After ARDS: Long-Term Outcomes

What's Next After ARDS: Long-Term Outcomes

Hospital-Level Factors Associated with Report of Physical Activity in Patients on Mechanical Ventilation across Washington State

Spurious Inferences about Long-Term Outcomes

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