G. Schelling et al., Pulmonary function and health-related quality of life in a sample of long-term survivors of the acute respiratory distress syndrome, INTEN CAR M, 26(9), 2000, pp. 1304-1311
Objective: We performed a follow-up cohort analysis in order to delineate t
he correlation between pulmonary function (PF) and health-related quality o
f life (HRQL) in patients after ARDS.
Design: Follow-up cohort study.
Setting: A 20-bed ICU of a university teaching hospital.
Patients: A cohort of 50 long-term survivors of ARDS.
Measurements and results: Measurements of PF (FVC, FEV1, TLC, D-LCO) and HR
QL (SF-36 Health Status Questionnaire) were made 5.5 years (median value) a
fter discharge from the ICU. Impairments in PF (defined as PF results below
80% of the predicted value) were frequent but generally mild. Twenty patie
nts had a single PF impairment (with limitations in FEV1/FVC ratio in 12 pa
tients being the most common), four patients had two (with D-LCO and FEV1/F
VC ratio impairment the most common) and three patients had pathologic resu
lts in three PF tests (FEV1/FVC ratio, TLC and capillary pO(2) during exerc
ise in one case, FVC, TLC and capillary pO(2) during exercise in the second
patient and FVC, TLC and D-LCO in the third). Compared to normal controls,
survivors of ARDS showed impairments in all SF36 health dimensions (p < 0.
001). Patients with multiple (> 1) PF impairments described the lowest HRQL
with major limitations in all SF-36 categories (p < 0.037) including physi
cal and mental summary scores (36.5 vs 46.9, p = 0.037 and 31.3 vs 51.4, p
= 0.003) when compared to patients with no or only one PF impairment.
Conclusions: Long-term survivors of ARDS have a significant reduction in HR
QL and the presence of multiple PF impairments is associated with maximal d
ecrements in HRQL.