title: One-year resource utilisation, costs and quality of life in patients with acute respiratory distress syndrome (ARDS): secondary analysis of a randomised controlled trial.
abstract: BACKGROUND
  The long-term economic and quality-of-life outcomes of patients admitted to intensive care unit (ICU) with acute respiratory distress syndrome are not well understood. In this study, we investigate 1-year costs, survival and quality of life following ICU admission in patients who required mechanical ventilation for acute respiratory distress syndrome.
  
  
  METHODS
  Economic analysis of data collected alongside a UK-based multi-centre randomised, controlled trial, aimed at comparing high-frequency oscillatory ventilation with conventional mechanical ventilation. The study included 795 critically ill patients admitted to ICU. Hospital costs were assessed using daily data. Post-hospital healthcare costs, patient out-of-pocket expenses, lost earnings of survivors and their carers and health-related quality of life were assessed using follow-up surveys.
  
  
  RESULTS
  The mean cost of initial ICU stay was £26,857 (95 % CI £25,222-£28,491), and the average daily cost in ICU was £1738 (CI £1667-£1810). Following hospital discharge, the average 1-year cost among survivors was £7523 (CI £5692-£9354). The mean societal cost at 1 year was £44,077 (£41,168-£46,985), and the total societal cost divided by the number of 1-year survivors was £90,206. Survivors reported significantly lower health-related quality of life than the age- and sex-matched reference population, and this difference was more marked in younger patients.
  
  
  CONCLUSIONS
  Given the high costs and low health-related quality of life identified, there is significant scope for further research aimed at improving care in this in-need patient group.
  
  
  BACKGROUND
  ISRCTN10416500.
authors.affiliation: Centre for Health Policy, Imperial College London, Praed Street, London, W2 1NY UK.
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authors.affiliation: Edinburgh Cancer Research Centre, University of Edinburgh, Crewe Road South, Edinburgh, EH4 2XR UK.
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authors.affiliation: Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK.
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authors.affiliation: Oxford Clinical Trials Unit, University of Oxford, Oxford, UK.
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authors.affiliation: Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.
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