Survivors of acute respiratory distress syndrome: Relationship between pulmonary dysfunction and long-term health-related quality of life
Survivors of acute respiratory distress syndrome: Relationship between pulmonary dysfunction and long-term health-related quality of life
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DOI：
10.1097/01.ccm.0000168609.98847.50
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发表时间：
2005-07-01
影响因子：
8.8
通讯作者：
Caeser, M
中科院分区：
文献类型：
--
作者：
Heyland, DK;Groll, D;Caeser, M
背景急性呼吸窘迫综合征（ARDS）幸存的患者通常报告出院后总体健康相关生活质量（HRQOL）下降。这种损害在多大程度上是由肺部或非肺部原因引起的尚不清楚。我们描述的模式恢复的患者幸存的ARDS照亮肺肺活量值，肺部症状，和整体HRQOL.Methods之间的任何关系：七十三个幸存者的ARDS被纳入了一项为期12个月的随访研究的一部分，III期随机，多中心试验。患者在3，6，12个月后，登记完成通用和疾病特异性HRQOL问卷调查，并进行肺肺活量测试performed.Results：所有领域的医疗成果研究简表-36（SF-36）和圣乔治的呼吸问卷（SGRQ）在所有时间间隔，ARDS的幸存者有显着低于年龄和性别匹配的人口值的分数。在12个月的随访期内，我们观察到总体身体健康评分显著改善，但SF-36的精神健康评分和SGRQ评分无统计学差异。身体机能测量表明，到12个月时，57%的人没有恢复“正常活动”。“在12个月时，肺肺活量测试显示随着时间的推移而稳定的轻度异常（分别有64%和49%的患者1秒用力呼气量[FEV 1]和用力肺活量[FVC]< 80%）。在12个月时，1秒用力呼气量与SF-36的身体功能领域密切相关（相关系数= 0.601; p <0.01），与SGRQ的所有领域中度相关（相关系数=-0.36，-50;所有病例p <0.01）。此外，SF-36和SGRQ的各个领域之间存在一些强至中度相关性。ARDS的幸存者有相当多的呼吸道症状和HRQOL降低，在损伤发生后12个月仍然普遍存在。肺功能测定、肺部症状和总体HRQOL之间存在显著相关性，因此表明急性肺损伤/ARDS对观察到的长期结局有因果关系。
Background. Patients who survive acute respiratory distress syndrome (ARDS) often report decreased general health-related quality of life (HRQOL) following hospital discharge. The extent to which this impairment is due to pulmonary or nonpulmonary causes is unclear. We describe the pattern of recovery of patients surviving ARDS to illuminate any relationships between lung spirometry values, pulmonary symptoms, and overall HRQOL.Methods: Seventy-three survivors of ARDS were enrolled in a 12-month follow-up study as part of a phase III randomized, multicenter trial. Patients were contacted at 3, 6, and 12 months after enrollment to complete generic and disease-specific HRQOL questionnaires and have lung spirometry tests performed.Results: For all domains of the Medical Outcomes Study Short Form-36 (SF-36) and the St. George's Respiratory Questionnaire (SGRQ) at all time intervals, survivors of ARDS had significantly lower scores than age- and sex-matched population values. Over the 12-month follow-up period, we observed significant improvements to the overall Physical Component Score, but the Mental Component Score of the SF-36 and the SGRQ scores were not statistically different. Physical performance measures suggested that by 12 months, 57% had not returned to "normal activity." At 12 months, lung spirometry tests demonstrated mild abnormalities that were stable over time (64% and 49% had < 80% predicted forced expiratory volume in 1 sec [FEV1] and forced vital capacity [FVC], respectively). At 12 months, the forced expiratory volume in 1 sec correlated strongly with the physical function domain of the SF-36 (correlation coefficient = 0.601; p < .01) and moderately with all domains of the SGRQ (correlation coefficient = -0.36, -50; p < .01 in all cases). In addition, there were several strong to moderate correlations between the various domains of the SF-36 and SGRQ.Conclusions. Survivors of ARDS have considerable respiratory symptoms and reduced HRQOL that is still prevalent at 12 mos following onset of injury. There are Significant correlations between lung spirometry, pulmonary symptoms, and overall HRQOL, thus suggesting the acute lung injury/ARDS is causally contributing to the observed long-term outcome.