Return to work and lost earnings after acute respiratory distress syndrome: a 5-year prospective, longitudinal study of long-term survivors

Kamdar, Biren B.; Sepúlveda, Kristin A.; Chong, Alexandra; Lord, Robert K.; Dinglas, Victor D.; Mendez-Tellez, Pedro A.; Shanholtz, Carl; Colantuoni, Elizabeth; Wachter, Till M. von; Pronovost, Peter J.; Needham, Dale M.

doi:10.1136/thoraxjnl-2017-210217

Cited by 96 publications

(104 citation statements)

References 42 publications

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“…Nevertheless, the fact remains that nearly 50% of patients were unemployed, which may have resulted in family problems and loss of substantial earnings. A 5-year follow-up of ARDS survivors showed that nearly one-third of previously employed ARDS survivors had never returned to work [33].…”

Section: Discussionmentioning

confidence: 99%

Tracheostomy in patients with acute respiratory distress syndrome is not related to quality of life, symptoms of psychiatric disorders or return-to-work: the prospective DACAPO cohort study

Blecha

Brandl

Zeman

et al. 2020

Ann. Intensive Care

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Background: Acute respiratory distress syndrome (ARDS) is a life-threatening condition that often requires prolonged mechanical ventilation. Tracheostomy is a common procedure with some risks, on the other hand with potential advantages over orotracheal intubation in critically ill patients. This study investigated the association of tracheostomy with health-related quality of life (HRQoL), symptoms of psychiatric disorders and return-to-work of ARDS survivors.Methods: Data were collected in the context of the prospective observational German-wide DACAPO study. Clinical and demographic patient data and treatment characteristics were obtained from the participating intensive care units (ICU). HRQoL and return-to-work were assessed using patient-reported questionnaires 3, 6 and 12 months after ICU discharge. HRQoL was measured with the Physical and Mental Component Scale of the Short-Form 12 Questionnaire (PCS-12, MCS-12). The prevalence of psychiatric symptoms (depression and post-traumatic stress disorder [PTSD]) was assessed using the Patient Health Questionnaire-9 and the Post-Traumatic Stress Syndrome-14. Physician-diagnosed anxiety and obsessive-compulsive disorder were recorded by patient self-report in the follow-up questionnaires. The associations of tracheostomy with HRQoL, psychiatric symptoms and return-to-work after 12 months were investigated by means of multivariable linear and logistic regression models.Results: Primary 877 ARDS patients (mean ± standard deviation: 54 ± 16 years, 68% male) survived and were discharged from ICU. Out of these patients, 478 (54.5%) were tracheotomised during ICU treatment. After 12 months, patient-reported outcomes could be analysed of 388 (44.2%) respondents, 205 with tracheostomy and 183 without. One year after ICU discharge, tracheostomy showed no significant association with physical or mental health-related quality of life (PCS-12: − 0.73 [− 3.96, 2.51]; MCS-12: − 0.71 [− 4.92, 3.49]), symptoms of psychiatric disorders (depression: 0.10 [− 1.43, 1.64]; PTSD: 3.31 [− 1.81, 8.43]; anxiety: 1.26 [0.41, 3.86]; obsessive-compulsive disorder: 0.59 [0.05, 6.68]) or return-to-work (0.71 [0.31, 1.64]) in the multivariable analysis (OR [95%-CI]).

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Section: Discussionmentioning

confidence: 99%

Tracheostomy in patients with acute respiratory distress syndrome is not related to quality of life, symptoms of psychiatric disorders or return-to-work: the prospective DACAPO cohort study

Blecha

Brandl

Zeman

et al. 2020

Ann. Intensive Care

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“…Despite burgeoning interest in post-ICU outcomes, there remains an incomplete understanding of the epidemiology of delayed return to work after critical illness, including longitudinal trends, associated factors and lost earnings. Recent studies in previously employed survivors of critical illness found that 67% and 69% returned to work at 12 and 60 months, respectively, and more than 70% accrued substantial lost earnings 4 5. In order to better understand the effects of critical illness on return to work, we conducted a systematic review and meta-analysis of studies evaluating return to work following ICU hospitalisation in survivors of critical illness.…”

Section: Introductionmentioning

confidence: 99%

Return to work after critical illness: a systematic review and meta-analysis

Kamdar

Suri

Suchyta

et al. 2019

Thorax

Self Cite

202

138

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BackgroundSurvivors of critical illness often experience poor outcomes after hospitalisation, including delayed return to work, which carries substantial economic consequences.ObjectiveTo conduct a systematic review and meta-analysis of return to work after critical illness.MethodsWe searched PubMed, Embase, PsycINFO, CINAHL and Cochrane Library from 1970 to February 2018. Data were extracted, in duplicate, and random-effects meta-regression used to obtain pooled estimates.ResultsFifty-two studies evaluated return to work in 10 015 previously employed survivors of critical illness, over a median (IQR) follow-up of 12 (6.25–38.5) months. By 1–3, 12 and 42–60 months’ follow-up, pooled return to work prevalence (95% CI) was 36% (23% to 49%), 60% (50% to 69%) and 68% (51% to 85%), respectively (τ2=0.55, I2=87%, p=0.03). No significant difference was observed based on diagnosis (acute respiratory distress syndrome (ARDS) vs non-ARDS) or region (Europe vs North America vs Australia/New Zealand), but was observed when comparing mode of employment evaluation (in-person vs telephone vs mail). Following return to work, 20%–36% of survivors experienced job loss, 17%–66% occupation change and 5%–84% worsening employment status (eg, fewer work hours). Potential risk factors for delayed return to work include pre-existing comorbidities and post-hospital impairments (eg, mental health).ConclusionApproximately two-thirds, two-fifths and one-third of previously employed intensive care unit survivors are jobless up to 3, 12 and 60 months following hospital discharge. Survivors returning to work often experience job loss, occupation change or worse employment status. Interventions should be designed and evaluated to reduce the burden of this common and important problem for survivors of critical illness.Trial registration numberPROSPERO CRD42018093135.

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“…Recovery after ICU discharge among ARDS patients is an important challenge [22]. In fact, studies have shown that most ARDS survivors have lost their previous job and never resume employment post-discharge [23,24]. Critically ill patients in the United States who do not have health insurance receive fewer critical care services and may experience worse clinical outcomes [25].…”

Section: Discussionmentioning

confidence: 99%

Association of Economic Status and Mortality in Patients with Acute Respiratory Distress Syndrome

Song

Lee

2020

IJERPH

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The high cost of treatment for acute respiratory distress syndrome (ARDS) is a concern for healthcare systems, while the impact of patients’ socio-economic status on the risk of ARDS-associated mortality remains controversial. This study investigated associations between patients’ income at the time of ARDS diagnosis and ARDS-specific mortality rate after treatment initiation. Data from records provided by the National Health Insurance Service of South Korea were used. Adult patients admitted for ARDS treatment from 2013 to 2017 were included in the study. Patients’ income in the year of diagnosis was evaluated. A total of 14,600 ARDS cases were included in the analysis. The 30-day and 1-year mortality rates were 48.6% and 70.3%, respectively. In multivariable Cox regression model, we compared income quartiles, showing that compared to income strata Q1, the Q2 (p = 0.719), Q3 (p = 0.946), and Q4 (p = 0.542) groups of income level did not affect the risk of 30-day mortality, respectively. Additionally, compared to income strata Q1, the Q2 (p = 0.762), Q3 (p = 0.420), and Q4 (p = 0.189) strata did not affect the risk of 1-year mortality. Patient income at the time of ARDS diagnosis did not affect the risk of 30-day or 1-year mortality in the present study based on South Korea’s health insurance data.

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Return to work and lost earnings after acute respiratory distress syndrome: a 5-year prospective, longitudinal study of long-term survivors

Cited by 96 publications

References 42 publications

Tracheostomy in patients with acute respiratory distress syndrome is not related to quality of life, symptoms of psychiatric disorders or return-to-work: the prospective DACAPO cohort study

Tracheostomy in patients with acute respiratory distress syndrome is not related to quality of life, symptoms of psychiatric disorders or return-to-work: the prospective DACAPO cohort study

Return to work after critical illness: a systematic review and meta-analysis

Association of Economic Status and Mortality in Patients with Acute Respiratory Distress Syndrome

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