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Am J Respir Crit Care Med. 2006 Sep 1;174(5):538-44. Epub 2006 Jun 8.

Two-year outcomes, health care use, and costs of survivors of acute respiratory distress syndrome.

Author information

  • 1Department of Medicine, University Health Network, Toronto, ON, Canada. angela.cheung@uhn.on.ca

Abstract

RATIONALE:

Little is known about the long-term outcomes and costs of survivors of acute respiratory distress syndrome (ARDS).

OBJECTIVES:

To describe functional and quality of life outcomes, health care use, and costs of survivors of ARDS 2 yr after intensive care unit (ICU) discharge.

METHODS:

We recruited a cohort of ARDS survivors from four academic tertiary care ICUs in Toronto, Canada, and prospectively monitored them from ICU admission to 2 yr after ICU discharge.

MEASUREMENTS:

Clinical and functional outcomes, health care use, and direct medical costs.

RESULTS:

Eighty-five percent of patients with ARDS discharged from the ICU survived to 2 yr; overall 2-yr mortality was 49%. At 2 yr, survivors continued to have exercise limitation although 65% had returned to work. There was no statistically significant improvement in health-related quality of life as measured by Short-Form General Health Survey between 1 and 2 yr, although there was a trend toward better physical role at 2 yr (p = 0.0586). Apart from emotional role and mental health, all other domains remained below that of the normal population. From ICU admission to 2 yr after ICU discharge, the largest portion of health care costs for a survivor of ARDS was the initial hospital stay, with ICU costs accounting for 76% of these costs. After the initial hospital stay, health care costs were related to hospital readmissions and inpatient rehabilitation.

CONCLUSIONS:

Survivors of ARDS continued to have functional impairment and compromised health-related quality of life 2 yr after discharge from the ICU. Health care use and costs after the initial hospitalization were driven by hospital readmissions and inpatient rehabilitation.

PMID:
16763220
[PubMed - indexed for MEDLINE]
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