One-year outcomes and health care utilization in survivors of severe acute respiratory syndrome
One-year outcomes and health care utilization in survivors of severe acute respiratory syndrome
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DOI：
10.1001/archinte.167.12.1312
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发表时间：
2007-06-25
影响因子：
--
通讯作者：
Herridge, Margaret S.
中科院分区：
文献类型：
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作者：
Tansey, Catherine M.;Louie, Marie;Herridge, Margaret S.
背景：严重急性呼吸系统综合症 (SARS) 于 2003 年成为全球流行病。缺乏有关一年结果和医疗保健利用的综合信息。 SARS 爆发期间进行的研究可能有助于为未来突发公共卫生事件的研究计划提供信息。本研究的目的是评估 SARS 幸存者及其家庭照顾者的 1 年结果。方法：该研究是前瞻性和观察性的。我们对来自安大略省多伦多市的 117 名 SARS 幸存者进行了评估。患者接受采访并接受体检、肺功能测试、胸部X光检查、6分钟步行测试、生活质量测量以及医疗保健利用情况的自我报告。第 1 年，确定非正式护理人员，对护理人员负担进行调查。结果：纳入的 SARS 幸存者很年轻（中位年龄 42 岁），大多数是女性（67%）和医护人员（65%）。出院1年后，肺功能指标处于正常范围，但18%的患者6分钟步行距离显着减少。医疗结果研究 36 项简短健康调查 (SF-36) 领域在 1 年时比正常值低 0.3 至 1.0 个标准差。在这些患者中，17% 的人在 1 年前还没有重返工作岗位。 51 名患者需要去看精神病学或心理学医生 668 次。在 SARS 流行期间，非正式护理人员报告 SF-36 的心理成分得分比正常值下降了 1.6 个标准差。结论：大多数 SARS 幸存者的身体恢复良好，但一些患者及其护理人员报告 1 年后心理健康状况显着下降。减轻流行病给患者和家庭护理人员造成的心理负担的策略应被视为未来大流行规划的一部分。
Background: Severe Acute Respiratory Syndrome (SARS) became a global epidemic in 2003. Comprehensive information on 1-year outcomes and health care utilization is lacking. Research conducted during the SARS outbreak may help inform research planning for future public health emergencies. The objective of this study was to evaluate the 1-year outcomes in survivors of SARS and their family caregivers.Method: The study was prospective and observational. We evaluated 117 SARS survivors from Toronto, Ontario. Patients were interviewed and underwent physical examination, pulmonary function testing, chest radiography, a 6-minute-walk test, quality-of-life measures, and self-report of health care utilization. At 1 year, informal caregivers were identified for a survey on caregiver burden.Results: The enrolled survivors of SARS were young (median age, 42 years), and most were women (67%) and health care workers (65%). At 1 year after hospital discharge, pulmonary function measures were in the normal range, but 18% of patients had a significant reduction in distance walked in 6 minutes. The Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) domains were 0.3 to 1.0 SD below normal at 1 year. Of the patients, 17% had not returned to work by 1 year. Fifty-one patients required 668 visits to psychiatry or psychology practitioners. During the SARS epidemic, informal caregivers reported a decline of 1.6 SD below normal on the mental component score of the SF-36.Conclusions: Most SARS survivors had good physical recovery from their illness, but some patients and their caregivers reported a significant reduction in mental health 1 year later. Strategies to ameliorate the psychological burden of an epidemic on the patient and family caregiver should be considered as part of future pandemic planning.