Recovery, Risks, and Adverse Health Outcomes in Year 1 After Extracorporeal Membrane Oxygenation.

BACKGROUND: Cross-sectional studies suggest that patients treated with extracorporeal membrane oxygenation (ECMO) have adverse health outcomes and high risk for mental health problems after discharge.
OBJECTIVES: To describe the recovery of discharged patients during the first year after ECMO.
METHODS: In a prospective cohort study, data were collected 3, 6, and 12 months after discontinuation of ECMO and discharge. Postal surveys included the 36-Item Short Form Health Survey, the EuroQol-5-Dimensions-5-Levels health questionnaire, the Hospital Anxiety and Depression Scale, and the Impact of Event Scale-Revised. Telephone interviews were used to track adverse physical outcomes. The Telephone Interview for Cognitive Status questionnaire was administered at the end of each call.
RESULTS: Patients in the study experienced more physical than mental adverse health outcomes, and the risk for mental problems was 2 or 3 times the rate expected. Adverse physical outcomes were common. One-quarter of patients remained significantly restricted; some had severe neurological impairments of the lower extremities. On cognitive tests, about half scored inconclusive or mildly impaired. Patients were often admitted to the hospital.
CONCLUSIONS: Physical health was more severely impaired than was mental health, and both types improved over time. The EuroQol-5-Dimensions-5-Levels instrument was useful for detecting neurological problems of the lower extremities early and may qualify as a core outcome measure for patients treated with ECMO. ©2017 American Association of Critical-Care Nurses.