title: Health-Related Quality of Life in Australasian Survivors of H1N1 Influenza Undergoing Mechanical Ventilation. A Multicenter Cohort Study.
abstract: BACKGROUND
  Patients surviving acute respiratory distress syndrome suffer decrements in physical function and health-related quality of life (HR-QoL); however, it is unclear whether HR-QoL is disproportionately affected in those with H1N1 influenza.
  
  
  OBJECTIVE
  The objective was to compare the HR-QoL of patients with a diagnosis of H1N1 influenza who were mechanically ventilated, 12 months after intensive care unit (ICU) discharge with healthy population data and ICU survivor data.
  
  
  METHODS
  A prospective, observational, binational, multicenter cohort study was conducted in 11 ICUs in Australia and New Zealand during June-September 2009. Eligible participants were mechanically ventilated in the ICU with a confirmed diagnosis of H1N1 influenza. People were excluded if they were less than 18 years of age or could not speak English. Two validated HR-QoL questionnaires (Short Form-36 version 2 [SF-36], and Assessment of Quality of Life [AQoL]) were administered 1 year after ICU discharge.
  
  
  RESULTS
  Sixty-two patients (48% male) had a median (interquartile range) age of 42 (29-53) years and an APACHE II score of 18.0 (14-20); ventilation days, 10.0 (4-23); and ICU and hospital length of stay, 12.5 (7-27) and 20.0 (15-38) days, respectively. Hospital mortality was 7%, and 31% of the cohort received a tracheostomy. The mean (SD) health utility score at 1 year was 0.68 (0.30) compared with the healthy age-matched population (0.81 [0.23]). The mean (SD) SF-36 physical and mental component summary scores were within population normal ranges at 44.4 (12.3) and 45.5 (12.5), respectively.
  
  
  CONCLUSIONS
  Health-related quality of life of Australasian survivors of severe H1N1 influenza was comparable to the healthy population 1 year after ICU discharge. Consensus should be sought on standardization of follow-up time points and outcome measurement. Clinical trial registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12609001037291).
authors: 1 Department of Physiotherapy, Western Health, Footscray, Victoria, Australia.|2 Allied Health Research Unit, Faculty of Medicine Nursing and Health Science, Monash University, Frankston, Victoria, Australia.|3 School of Physiotherapy, Faculty of Medicine Nursing and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.|4 Department of Physiotherapy, Austin Health, Heidelberg, Victoria, Australia.
authors: Elizabeth H
authors: EH
authors: Skinner
authors: 3 School of Physiotherapy, Faculty of Medicine Nursing and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.|4 Department of Physiotherapy, Austin Health, Heidelberg, Victoria, Australia.|5 Department of Physiotherapy, St. Vincent's Hospital, Fitzroy, Victoria, Australia.
authors: Kimberley J
authors: KJ
authors: Haines
authors: 6 Australia and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.
authors: Belinda
authors: B
authors: Howe
authors: 6 Australia and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.|7 Department of Physiotherapy, The Alfred, Prahran, Melbourne, Victoria, Australia.
authors: Carol L
authors: CL
authors: Hodgson
authors: 3 School of Physiotherapy, Faculty of Medicine Nursing and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.
authors: Linda
authors: L
authors: Denehy
authors: 8 Department of Critical Care Medicine, Auckland City Hospital, Grafton, New Zealand; and.
authors: Colin J
authors: CJ
authors: McArthur
authors: 5 Department of Physiotherapy, St. Vincent's Hospital, Fitzroy, Victoria, Australia.
authors: Daniel
authors: D
authors: Seller
authors: 5 Department of Physiotherapy, St. Vincent's Hospital, Fitzroy, Victoria, Australia.
authors: Emma
authors: E
authors: Di Marco
authors: 9 Department of Physiotherapy, Royal Melbourne Hospital, Parkville, Victoria, Australia; and.
authors: Kate
authors: K
authors: Mulvany
authors: 10 Department of Physiotherapy, Monash Health, Clayton, Victoria, Australia.
authors: Danielle T
authors: DT
authors: Ryan
authors: 3 School of Physiotherapy, Faculty of Medicine Nursing and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia.|4 Department of Physiotherapy, Austin Health, Heidelberg, Victoria, Australia.
authors: Sue
authors: S
authors: Berney
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012121:Respiration, Artificial / Q000379:methods; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: acute respiratory distress syndrome; influenza; intensive care unit; mechanical ventilation; quality of life