Functional Disability 5 Years after Acute Respiratory Distress Syndrome
Functional Disability 5 Years after Acute Respiratory Distress Syndrome
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DOI：
10.1056/nejmoa1011802
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发表时间：
2011-04-07
影响因子：
158.5
通讯作者：
Cheung, Angela M.
中科院分区：
文献类型：
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作者：
Herridge, Margaret S.;Tansey, Catherine M.;Cheung, Angela M.
关于急性呼吸窘迫综合征（ARDS）幸存者5年预后的详细的、面对面的访谈和随访数据很少。方法我们评估了109例ARDS患者在重症监护病房出院后3、6、12个月以及2、3、4、5年的存活情况。在每次访问中，对患者进行访谈和检查；接受肺功能测试、6分钟步行测试、静息和运动血氧仪、胸部成像和生活质量评估；并报告了他们使用医疗服务的情况。结果5年内，6分钟步行距离中位数为436米（预测距离的76%），医疗结果研究36项简短健康调查的身体成分得分为41分（年龄和性别匹配的平均标准得分为50分）。根据这一评分，年轻患者的康复率高于老年患者，但两组在5年后都没有恢复到正常的预期身体功能水平。肺功能正常至接近正常。在患者和家庭照顾者中出现或持续了长达5年的其他一系列身体和心理问题。同时存在更多疾病的患者5年费用更高。结论运动受限、身心后遗症、身体生活质量下降、卫生保健服务费用和使用增加是严重肺损伤的重要后遗症。
BACKGROUNDThere have been few detailed, in-person interviews and examinations to obtain follow-up data on 5-year outcomes among survivors of the acute respiratory distress syndrome (ARDS).METHODSWe evaluated 109 survivors of ARDS at 3, 6, and 12 months and at 2, 3, 4, and 5 years after discharge from the intensive care unit. At each visit, patients were interviewed and examined; underwent pulmonary-function tests, the 6-minute walk test, resting and exercise oximetry, chest imaging, and a quality-of-life evaluation; and reported their use of health care services.RESULTSAt 5 years, the median 6-minute walk distance was 436 m (76% of predicted distance) and the Physical Component Score on the Medical Outcomes Study 36-Item Short-Form Health Survey was 41 (mean norm score matched for age and sex, 50). With respect to this score, younger patients had a greater rate of recovery than older patients, but neither group returned to normal predicted levels of physical function at 5 years. Pulmonary function was normal to near-normal. A constellation of other physical and psychological problems developed or persisted in patients and family caregivers for up to 5 years. Patients with more coexisting illnesses incurred greater 5-year costs.CONCLUSIONSExercise limitation, physical and psychological sequelae, decreased physical quality of life, and increased costs and use of health care services are important legacies of severe lung injury.