title: General anxiety symptoms after acute lung injury: predictors and correlates.
abstract: OBJECTIVE
  Acute lung injury (ALI) is common in the intensive care unit (ICU), typically requiring life support ventilation. Survivors often experience anxiety after hospital discharge. We evaluated general anxiety symptoms 3 months after ALI for: (1) associations with patient characteristics and ICU variables, and (2) cross-sectional associations with physical function and quality of life (QOL).
  
  
  METHODS
  General anxiety was assessed as part of a prospective cohort study recruiting patients from 13 ICUs at four hospitals in Baltimore, MD using the Hospital Anxiety and Depression Scale--Anxiety Subscale (HAD-A), with associations evaluated using multivariable linear and logistic regression models.
  
  
  RESULTS
  Of 152 patients, 38% had a positive screening test for general anxiety (HAD-A≥8). Pre-ICU body mass index and psychiatric comorbidity were associated with general anxiety (OR, 95% confidence interval (CI): 1.06 (1.00, 1.13) and 3.59 (1.25, 10.30), respectively). No ICU-related variables were associated with general anxiety. General anxiety was associated with the number of instrumental ADL dependencies (Spearman's rho=0.22; p=0.004) and worse overall QOL as measured by EQ-5D visual analog scale (VAS) (rho=-0.34; p<0.001) and utility score (rho=-0.30; p<0.001), and by the SF-36 mental health domain (rho=-0.70; p<0.001) and Mental Component Summary score (rho=-0.73; p<0.001).
  
  
  CONCLUSIONS
  Many patients have substantial general anxiety symptoms 3 months after ALI. General anxiety was associated with patient characteristics and impaired physical function and quality of life. Early identification and treatment of general anxiety may enhance physical and emotional function in patients surviving critical illnesses.
authors: Department of Physical Medicine and Rehabilitation, the Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors: Jennifer E
authors: JE
authors: Stevenson
authors: Elizabeth
authors: E
authors: Colantuoni
authors: O Joseph
authors: OJ
authors: Bienvenu
authors: Thiti
authors: T
authors: Sricharoenchai
authors: Amy
authors: A
authors: Wozniak
authors: Carl
authors: C
authors: Shanholtz
authors: Pedro A
authors: PA
authors: Mendez-Tellez
authors: Dale M
authors: DM
authors: Needham
mesh_terms: D055371:Acute Lung Injury / Q000150:complications* / Q000523:psychology; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: Acute lung injury, adult; Anxiety; Critical care; Intensive care units; Physical function; Quality of life; Respiratory distress syndrome, adult
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