Quality-adjusted survival in the first year after the acute respiratory distress syndrome
Quality-adjusted survival in the first year after the acute respiratory distress syndrome
复制标题
DOI：
10.1164/ajrccm.163.6.2005123
复制
发表时间：
2001-05-01
影响因子：
24.7
通讯作者：
Pinsky, MR
中科院分区：
文献类型：
--
作者：
Angus, DC;Musthafa, AA;Pinsky, MR
关于急性呼吸窘迫综合征（ARDS）后的长期预后信息很少。我们在一个前瞻性队列中测量了ARDS后第一年的质量调整生存率（n = 200）。所有患者均符合ARDS的传统标准。脓毒症和急性非肺器官功能障碍的患者被排除在外。该队列在ARDS发作前是健康的，如高功能状态（平均Karnofsky体能状态指数：82.2/100，其中大于或等于80 =能够独立进行正常活动）和最小共病（平均Charlson-Deyo共病评分：0.32/17，其中0 =没有慢性疾病）所证明的。我们使用幸福质量（QWB）量表（0至1量表，其中1 =最佳幸福）确定质量调整生命年（QWB），在6个月和12个月时测量。1个月时生存率为69.5 ± 5.0%，6个月时降至55.7 ± 3.7%，12个月时无变化，每100例ARDS患者第一年的生存率为59生命年。QWB在6个月和12个月时较低（0.59 +/- 0.015和0.60 +/- 0.015），质量调整生存率为36 QWB/100例患者（敏感性范围：21至46 QWB）。我们的结论是，在以前健康的患者中发展的ARDS与较差的质量调整生存率相关。这些数据对于成本效益分析和长期护理非常重要。
There is little information on long-term outcome after acute respiratory distress syndrome (ARDS). We measured quality-adjusted survival in the first year after ARDS in a prospective cohort (n = 200). All patients met traditional criteria for ARDS. Patients with sepsis and acute nonpulmonary organ dysfunction at presentation were excluded. The cohort was healthy before onset of ARDS as evidenced by high functional status (mean Karnofsky Performance Status index: 82.2/100 where greater than or equal to 80 = able to perform normal activities independently) and minimal comorbid illness (mean Charlson-Deyo comorbidity score: 0.32/17 where 0 = absence of chronic illness). We determined quality-adjusted life-years (QALYs) using the Quality of Well-being (QWB) scale (0 to 1 scale where 1 = optimal well-being), measured at 6 and 12 mo. Survival was 69.5 +/- 5.0% at 1 month, fell to 55.7 +/- 3.7% at 6 mo, and did not change at 12 mo, yielding a survival of 59 life-years in the first year per 100 patients with ARDS. QWB was low at 6 and 12 mo (0.59 +/- 0.015 and 0.60 +/- 0.015), yielding a quality-adjusted survival of 36 QALYs per 100 patients (sensitivity range: 21 to 46 QALYs). We conclude that ARDS developing in previously healthy patients is associated with poor quality-adjusted survival. These data are important for cost-effectiveness analyses and long-term care.