Quality of life in survivors of prolonged mechanical ventilatory support.
OBJECTIVE
To examine the long-term quality of life (QOL) in a group of patients after prolonged mechanical ventilatory support.


METHODS
Prospective cohort study.


METHODS
Outpatient follow-up.


METHODS
Survivors of prolonged mechanical ventilatory support who were discharged from a ventilator rehabilitation unit (VRU).


METHODS
Measurement of health-related QOL using the Sickness Impact Profile (SIP).


RESULTS
Forty-six patients were contacted approximately 2 yrs after their discharge from the VRU and asked to complete the SIP. Twenty-five patients (age, 59 +/- 17 yrs; duration of mechanical ventilatory support, 45 +/- 36 days [mean +/- sd]) agreed to participate in this study and completed the SIP questionnaire 23 +/- 18 months after their discharge from the VRU. Patients' VRU stay was 29 +/- 21 days. Two patients were discharged with nocturnal ventilatory support, and the rest were completely weaned of mechanical ventilatory support before discharge. Fifteen patients (60%) were discharged to home, eight patients (32%) were discharged to a rehabilitation facility, and two patients (8%) were discharged to a skilled-care facility. Most patients had mild dysfunction, and the global SIP score was 12 +/- 10, the physical dimension score was 12 +/- 12, and the psychosocial dimension score was 9 +/- 11 (SIP scores range from 0 to 100, with higher scores indicating worse QOL). Subgroup analysis showed that postoperative patients had lower SIP scores compared with patients with chronic respiratory diseases (global SIP, 7 +/- 6 vs. 19 +/- 8; p <.05). Moreover, the patients in the postoperative group were older, but had similar SIP scores as patients who had acute lung injury (17 +/- 15). Global SIP scores correlated with age (r = -.40; p =.046), but not with duration of mechanical ventilatory support (r = -.23) or VRU admission Acute Physiology and Chronic Health Evaluation II scores (r = -.39; p =.06).


CONCLUSIONS
In survivors of prolonged mechanical ventilatory support, using specific selection criteria shows that there is minimal impairment in the QOL at long-term follow-up. Although some patients continue to have moderate to severe limitations, it is the cause of respiratory failure and the underlying disease, rather than duration of ventilatory support, that have a significant impact on QOL.
Chatila
W
W
Division of Pulmonary and Critical Care Medicine, the Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA. wissam@pol.net
Kreimer
D T
DT
Criner
G J
GJ
D018806:APACHE; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012047:Rehabilitation Centers; D012121:Respiration, Artificial; D012140:Respiratory Tract Diseases / Q000534:rehabilitation / Q000628:therapy*; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires