Sarah E Jolley1, Derek C Angus2, Gilles Clermont2, Catherine L Hough3. 1. Section of Pulmonary/Critical Care and Allergy/Immunology, Louisiana State University Health Sciences Center, New Orleans, LA. 2. The CRISMA Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA. 3. Division of Pulmonary and Critical Care Medicine, University of Washington School of Medicine, Seattle, WA.
Abstract
OBJECTIVES: Discharge destination is a commonly used surrogate for long-term recovery in rehabilitation studies. We determined the accuracy of discharge destination as a surrogate marker for 6-month mobility impairment in acute respiratory distress syndrome survivors. DESIGN/ SETTING: Secondary analysis of the Economic Analysis of Pulmonary Artery Catheters study, a long-term observational sub-study of the National Institutes of Health/National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network Fluid and Catheter Treatment Trial. PATIENTS: Patients underwent functional assessment using the Health Utilities Index-2 mobility domains at 6 months. A score greater than or equal to 3 (i.e., need for assistive device) defined mobility impairment. Discharge to any institutional care constituted a care facility discharge. We used logistic regression to explore the association between discharge destination and mobility impairment. We generated test characteristics and receiver operating characteristics to assess the accuracy of discharge destination as a surrogate for mobility impairment. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 591 patients were enrolled in Economic Analysis of Pulmonary Artery Catheters in whom 328 had functional measurements at 6 months with 116 (35%) of these patients discharged to a care facility. Care facility patients were older (mean age 53 vs 44 yr; p < 0.001) and had longer hospital durations (length of stay 29 vs 17 d; p < 0.001). Care facility discharge was associated with greater 6-month mobility impairment. Sensitivity and specificity of discharge to a care facility for mobility impairment were 40.5% (95% CI, 32.0-49.6%) and 79.3% (95% CI, 73.3-84.2%) at 6 months. Discharge destination alone was a poor discriminator of long-term mobility impairment (receiver operating characteristic area under the curve: 0.61 at 6 mo). CONCLUSIONS: Discharge to a care facility was strongly associated with mobility impairment 6 months after acute respiratory distress syndrome but discharge destination alone performed poorly as a surrogate for mobility impairment.
OBJECTIVES: Discharge destination is a commonly used surrogate for long-term recovery in rehabilitation studies. We determined the accuracy of discharge destination as a surrogate marker for 6-month mobility impairment in acute respiratory distress syndrome survivors. DESIGN/ SETTING: Secondary analysis of the Economic Analysis of Pulmonary Artery Catheters study, a long-term observational sub-study of the National Institutes of Health/National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network Fluid and Catheter Treatment Trial. PATIENTS: Patients underwent functional assessment using the Health Utilities Index-2 mobility domains at 6 months. A score greater than or equal to 3 (i.e., need for assistive device) defined mobility impairment. Discharge to any institutional care constituted a care facility discharge. We used logistic regression to explore the association between discharge destination and mobility impairment. We generated test characteristics and receiver operating characteristics to assess the accuracy of discharge destination as a surrogate for mobility impairment. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 591 patients were enrolled in Economic Analysis of Pulmonary Artery Catheters in whom 328 had functional measurements at 6 months with 116 (35%) of these patients discharged to a care facility. Care facility patients were older (mean age 53 vs 44 yr; p < 0.001) and had longer hospital durations (length of stay 29 vs 17 d; p < 0.001). Care facility discharge was associated with greater 6-month mobility impairment. Sensitivity and specificity of discharge to a care facility for mobility impairment were 40.5% (95% CI, 32.0-49.6%) and 79.3% (95% CI, 73.3-84.2%) at 6 months. Discharge destination alone was a poor discriminator of long-term mobility impairment (receiver operating characteristic area under the curve: 0.61 at 6 mo). CONCLUSIONS: Discharge to a care facility was strongly associated with mobility impairment 6 months after acute respiratory distress syndrome but discharge destination alone performed poorly as a surrogate for mobility impairment.
Authors: Dale M Needham; Victor D Dinglas; Peter E Morris; James C Jackson; Catherine L Hough; Pedro A Mendez-Tellez; Amy W Wozniak; Elizabeth Colantuoni; E Wesley Ely; Todd W Rice; Ramona O Hopkins Journal: Am J Respir Crit Care Med Date: 2013-09-01 Impact factor: 21.405
Authors: Peter Nydahl; A Parker Ruhl; Gabriele Bartoszek; Rolf Dubb; Silke Filipovic; Hans-Jürgen Flohr; Arnold Kaltwasser; Hendrik Mende; Oliver Rothaug; Danny Schuchhardt; Norbert Schwabbauer; Dale M Needham Journal: Crit Care Med Date: 2014-05 Impact factor: 7.598
Authors: Mark A Shulman; Paul S Myles; Matthew T V Chan; David R McIlroy; Sophie Wallace; Jennie Ponsford Journal: Anesthesiology Date: 2015-03 Impact factor: 7.892
Authors: Hannah Wunsch; Carmen Guerra; Amber E Barnato; Derek C Angus; Guohua Li; Walter T Linde-Zwirble Journal: JAMA Date: 2010-03-03 Impact factor: 56.272
Authors: Susan C Berney; Megan Harrold; Steven A Webb; Ian Seppelt; Shane Patman; Peter J Thomas; Linda Denehy Journal: Crit Care Resusc Date: 2013-12 Impact factor: 2.159
Authors: Sarah Elizabeth Jolley; Marc Moss; Dale M Needham; Ellen Caldwell; Peter E Morris; Russell R Miller; Nancy Ringwood; Megan Anders; Karen K Koo; Stephanie E Gundel; Selina M Parry; Catherine L Hough Journal: Crit Care Med Date: 2017-02 Impact factor: 7.598
Authors: Margaret S Herridge; Leslie M Chu; Andrea Matte; George Tomlinson; Linda Chan; Claire Thomas; Jan O Friedrich; Sangeeta Mehta; Francois Lamontagne; Melanie Levasseur; Niall D Ferguson; Neill K J Adhikari; Jill C Rudkowski; Hilary Meggison; Yoanna Skrobik; John Flannery; Mark Bayley; Jane Batt; Claudia Dos Santos; Susan E Abbey; Adrienne Tan; Vincent Lo; Sunita Mathur; Matteo Parotto; Denise Morris; Linda Flockhart; Eddy Fan; Christie M Lee; M Elizabeth Wilcox; Najib Ayas; Karen Choong; Robert Fowler; Damon C Scales; Tasnim Sinuff; Brian H Cuthbertson; Louise Rose; Priscila Robles; Stacey Burns; Marcelo Cypel; Lianne Singer; Cecelia Chaparro; Chung-Wai Chow; Shaf Keshavjee; Laurent Brochard; Paul Hebert; Arthur S Slutsky; John C Marshall; Deborah Cook; Jill I Cameron Journal: Am J Respir Crit Care Med Date: 2016-10-01 Impact factor: 21.405
Authors: Alison E Turnbull; Anahita Rabiee; Wesley E Davis; Mohamed Farhan Nasser; Venkat Reddy Venna; Rohini Lolitha; Ramona O Hopkins; O Joseph Bienvenu; Karen A Robinson; Dale M Needham Journal: Crit Care Med Date: 2016-07 Impact factor: 7.598
Authors: Eddy Fan; David W Dowdy; Elizabeth Colantuoni; Pedro A Mendez-Tellez; Jonathan E Sevransky; Carl Shanholtz; Cheryl R Dennison Himmelfarb; Sanjay V Desai; Nancy Ciesla; Margaret S Herridge; Peter J Pronovost; Dale M Needham Journal: Crit Care Med Date: 2014-04 Impact factor: 7.598
Authors: Matthew F Mart; Timothy D Girard; Jennifer L Thompson; Hannah Whitten-Vile; Rameela Raman; Pratik P Pandharipande; Daren K Heyland; E Wesley Ely; Nathan E Brummel Journal: Clin Nutr Date: 2021-05-11 Impact factor: 7.643