Joan R Masclans1, Oriol Roca2, Xavier Muñoz3, Esther Pallisa4, Ferran Torres5, Jordi Rello2, Ferran Morell3. 1. Department of Critical Care Medicine, Hospital Universitari Vall d'Hebron-Vall d'Hebron Research Institute-Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. Electronic address: jrmasclans@vhebron.net. 2. Department of Critical Care Medicine, Hospital Universitari Vall d'Hebron-Vall d'Hebron Research Institute-Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBERES, Instituto Salut Carlos III, Ministerio de Sanidad de España, IDIBAPS, Barcelona, Spain. 3. Department of Respiratory Medicine, Hospital Universitari Vall d'Hebron-Vall d'Hebron Research Institute-Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; CIBERES, Instituto Salut Carlos III, Ministerio de Sanidad de España, IDIBAPS, Barcelona, Spain. 4. Department of Radiology, Hospital Universitari Vall d'Hebron-Vall d'Hebron Research Institute-Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. 5. Laboratory of Biostatistics & Epidemiology (UAB), Statistics & Methodology Support Unit (USEM), IDIBAPS, Barcelona, Spain.
Abstract
BACKGROUND: ARDS can produce a loss of lung function with persistent sequelae. This study aimed to evaluate health-related quality of life (HRQL) in survivors of ARDS compared with a healthy reference population and to determine the middle/long-term radiographic abnormalities and functional status, as well as their relation to observed HRQL, in these patients. METHODS: This was a prospective study carried out in three ICUs. HRQL in patients was determined with the Nottingham Health Profile immediately after ARDS diagnosis and 6 months after diagnosis. Patients underwent complete respiratory function testing, chest CT scan study, and the 6-min walk test. RESULTS: Follow-up was conducted in 38 patients with ARDS. Survivors of ARDS presented a poorer overall HRQL vs the general population, mainly because of lower scores in the dimensions related to mobility, energy, and social isolation. Limitations in daily life activities were documented in 40%. Respiratory function was altered in 67%, with a restrictive respiratory pattern in 58%. Radiologic study disclosed alterations in 76% (mainly reticular pattern). Patients were able to cover only 366 m (318-411 m) in the 6-min walk test and had a minimum pulse oximetry of 93% (90%-94%). A significant correlation was documented between the overall quality of life at first and at 6 months (r = 0.68, P < .01). CONCLUSIONS: Survivors of ARDS after 6 months had a poorer HRQL than the healthy population and showed mild radiographic and functional involvement. Early HRQL study in these patients enabled early detection of those who would present more long-term HRQL morbidity.
BACKGROUND: ARDS can produce a loss of lung function with persistent sequelae. This study aimed to evaluate health-related quality of life (HRQL) in survivors of ARDS compared with a healthy reference population and to determine the middle/long-term radiographic abnormalities and functional status, as well as their relation to observed HRQL, in these patients. METHODS: This was a prospective study carried out in three ICUs. HRQL in patients was determined with the Nottingham Health Profile immediately after ARDS diagnosis and 6 months after diagnosis. Patients underwent complete respiratory function testing, chest CT scan study, and the 6-min walk test. RESULTS: Follow-up was conducted in 38 patients with ARDS. Survivors of ARDS presented a poorer overall HRQL vs the general population, mainly because of lower scores in the dimensions related to mobility, energy, and social isolation. Limitations in daily life activities were documented in 40%. Respiratory function was altered in 67%, with a restrictive respiratory pattern in 58%. Radiologic study disclosed alterations in 76% (mainly reticular pattern). Patients were able to cover only 366 m (318-411 m) in the 6-min walk test and had a minimum pulse oximetry of 93% (90%-94%). A significant correlation was documented between the overall quality of life at first and at 6 months (r = 0.68, P < .01). CONCLUSIONS: Survivors of ARDS after 6 months had a poorer HRQL than the healthy population and showed mild radiographic and functional involvement. Early HRQL study in these patients enabled early detection of those who would present more long-term HRQL morbidity.
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