The relationship between cognitive performance and employment and health status in long-term survivors of the acute respiratory distress syndrome: results of an exploratory study

Survivors of acute respiratory distress syndrome (ARDS) are at risk for lon g-lasting cognitive decline due to hypoxemia, sepsis and/or psychological s equelae associated with aggressive supportive care in the intensive care un it (ICU), We conducted an exploratory study to assess cognitive performance in long-term survivors of ARDS and to investigate how cognitive functionin g is related to employment status and health-related quality of life (HRQOL ). At median time of 6.0 years after ICU discharge, forty-six ARDS survivor s were tested with SE;T. a short cognitive performance test for assessing d eficits of memory and attention. A measure of HRQOL. (SF-36 Health Status Q uestionnaire) was also administered, and in a brief psychiatric interview, employment status was rated, 23.9% (n=11) of the patients showed cognitive impairments. However, no extreme and severe cognitive deficits were recorde d. They primarily revealed low levels of cognitive function in various task s assessing attention skills. Disability was found in 41.3% (n=19) of the p atients, All ARDS survivors with cognitive deficits were disabled, whereas only 22.9% (n=8) of the cognitively not impaired patients gave evidence of disability. The SF-36 values of the ARDS survivors indicated impaired healt h status on seven out of eight domains when compared to normative populatio n data. Patients with cognitive deficits described the lowest HRQOL with ma jor limitations in the domains role-physical and social functioning when co mpared to patients without cognitive impairments. In conclusion, long-term, ARDS survivors exhibit impaired health status and the presence of cognitiv e deficits is associated with disability and considerable impairments in HR QOL. More detailed psychiatric research is required to establish the etiolo gy of these cognitive impairments. (C) 2001 Elsevier Science Inc. All right s reserved.