title: Are physical measures related to patient-centred outcomes in ARDS survivors?
abstract: To inform selection of physical measures for studies of acute respiratory distress syndrome (ARDS) survivors within 12 months of ARDS.
  
  
  
  Secondary analysis of data from 6-month survivors participating in a US multicentre prospective study (ARDSNet Long-Term Outcome Study, N=134) or a multisite prospective study in Baltimore, Maryland, USA (Improving Care of Acute Lung Injury Patients, N=99). Physical measures, assessed at 6-month follow-up, were categorised according to the WHO's International Classification of Disability and Health: body functions and structures, activity and participation. Patient-centred outcomes were evaluated at 6 and 12 months: survival, hospitalisation, alive at home status and health-related quality of life. Pearson correlation, linear and logistic regression models were used to quantify associations of physical measures with patient-centred outcomes.
  
  
  
  No 6-month body functions and structures measure demonstrated consistent association with 6-month or 12-month outcomes in multivariable regression. The 6 min walk test, an activity measure, was associated with 6-month Short-Form 36 (SF-36) physical component scores (PCS, β range: 0.99 to 1.52, p<0.05). Participation measures (Functional Performance Inventory, FPI; Instrumental Activities of Daily Living, IADLs) were associated with SF-36 PCS (β range: FPI, 1.51-1.52; IADL, -1.88 to -1.32; all p<0.05) and Euro-QOL-5D utility score (β range: FPI, 2.00-3.67; IADL, -2.89 to -2.50; all p<0.01) at 6 and 12 months.
  
  
  
  Participation measures better reflect patient's quality of life than measures of body functions and structures within 12 months of ARDS among 6-month survivors, and are recommended for inclusion as a core measure in future studies.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: Kitty S
authors.initials: KS
authors.lastname: Chan
authors.affiliation: Outcomes after Critical Illness and Surgery Group, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.|Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Aronson Friedman
authors.affiliation: Outcomes after Critical Illness and Surgery Group, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.|Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Victor D
authors.initials: VD
authors.lastname: Dinglas
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, University of Washington, Seattle, Washington, USA.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Hough
authors.affiliation: Division of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, Maryland, USA.
authors.forename: Carl
authors.initials: C
authors.lastname: Shanholtz
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.|Geriatric Research, Education and Clinical Center Service, Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
authors.forename: E Wesley
authors.initials: EW
authors.lastname: Ely
authors.affiliation: Division of Pulmonary, Critical Care and Sleep Medicine, University of Kentucky, Lexington, Kentucky, USA.
authors.forename: Peter E
authors.initials: PE
authors.lastname: Morris
authors.affiliation: Outcomes after Critical Illness and Surgery Group, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.|Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Mendez-Tellez
authors.affiliation: Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
authors.forename: James C
authors.initials: JC
authors.lastname: Jackson
authors.affiliation: Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah, USA.|Center for Humanizing Critical Care, Intermountain Health Care, Murray, Utah, USA.|Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah, USA.
authors.forename: Ramona O
authors.initials: RO
authors.lastname: Hopkins
authors.affiliation: Outcomes after Critical Illness and Surgery Group, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.|Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.|Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Dale M
authors.initials: DM
authors.lastname: Needham
mesh_terms: D000203:Activities of Daily Living; D015142:Baltimore; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011446:Prospective Studies; D011788:Quality of Life; D012128:Respiratory Distress Syndrome / Q000503:physiopathology*; D017741:Survivors; D014481:United States
keywords: ARDS