Two-year outcomes, health care use, and costs of survivors of acute respiratory distress syndrome.
BACKGROUND
Little is known about the long-term outcomes and costs of survivors of acute respiratory distress syndrome (ARDS).


OBJECTIVE
To describe functional and quality of life outcomes, health care use, and costs of survivors of ARDS 2 yr after intensive care unit (ICU) discharge.


METHODS
We recruited a cohort of ARDS survivors from four academic tertiary care ICUs in Toronto, Canada, and prospectively monitored them from ICU admission to 2 yr after ICU discharge.


METHODS
Clinical and functional outcomes, health care use, and direct medical costs.


RESULTS
Eighty-five percent of patients with ARDS discharged from the ICU survived to 2 yr; overall 2-yr mortality was 49%. At 2 yr, survivors continued to have exercise limitation although 65% had returned to work. There was no statistically significant improvement in health-related quality of life as measured by Short-Form General Health Survey between 1 and 2 yr, although there was a trend toward better physical role at 2 yr (p = 0.0586). Apart from emotional role and mental health, all other domains remained below that of the normal population. From ICU admission to 2 yr after ICU discharge, the largest portion of health care costs for a survivor of ARDS was the initial hospital stay, with ICU costs accounting for 76% of these costs. After the initial hospital stay, health care costs were related to hospital readmissions and inpatient rehabilitation.


CONCLUSIONS
Survivors of ARDS continued to have functional impairment and compromised health-related quality of life 2 yr after discharge from the ICU. Health care use and costs after the initial hospitalization were driven by hospital readmissions and inpatient rehabilitation.
Cheung
Angela M
AM
Department of Medicine, University Health Network, Toronto, ON, Canada. angela.cheung@uhn.on.ca
Tansey
Catherine M
CM
Tomlinson
George
G
Diaz-Granados
Natalia
N
Matté
Andrea
A
Barr
Aiala
A
Mehta
Sangeeta
S
Mazer
C David
CD
Guest
Cameron B
CB
Stewart
Thomas E
TE
Al-Saidi
Fatma
F
Cooper
Andrew B
AB
Cook
Deborah
D
Slutsky
Arthur S
AS
Herridge
Margaret S
MS
D000328:Adult; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology; D012128:Respiratory Distress Syndrome / Q000191:economics* / Q000503:physiopathology / Q000628:therapy*; D012129:Respiratory Function Tests; D013997:Time Factors