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Understanding Patients' Perceived Health After Critical Illness: Analysis of Two Prospective, Longitudinal Studies of ARDS Survivors.
Turnbull, Alison E; Ji, Hongkai; Dinglas, Victor D; Wu, Albert W; Mendez-Tellez, Pedro A; Himmelfarb, Cheryl Dennison; Shanholtz, Carl B; Hosey, Megan M; Hopkins, Ramona O; Needham, Dale M.
  • Turnbull AE; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University,
  • Ji H; Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
  • Dinglas VD; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD.
  • Wu AW; Center for Health Services and Outcomes Research, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; Division of General Internal Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD.
  • Mendez-Tellez PA; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD.
  • Himmelfarb CD; Office for Science and Innovation, Johns Hopkins School of Nursing, Johns Hopkins University, Baltimore, MD.
  • Shanholtz CB; Division of Pulmonary and Critical Care Medicine, University of Maryland, Baltimore, MD.
  • Hosey MM; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD; Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins Uni
  • Hopkins RO; Center for Humanizing Critical Care, Intermountain Healthcare, Murray, UT; Psychology Department and Neuroscience Center, Brigham Young University, Provo, UT.
  • Needham DM; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD; Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins Uni
Chest ; 161(2): 407-417, 2022 02.
Article in English | MEDLINE | ID: covidwho-1363120
ABSTRACT

BACKGROUND:

Perceived health is one of the strongest determinants of subjective well-being, but it has received little attention among survivors of ARDS. RESEARCH QUESTION How well do self-reported measures of physical, emotional, and social functioning predict perceived overall health (measured using the EQ-5D visual analog scale [EQ-5D-VAS]) among adult survivors of ARDS? Are demographic features, comorbidity, or severity of illness correlated with perceived health after controlling for self-reported functioning? STUDY DESIGN AND

METHODS:

We analyzed the ARDSNet Long Term Outcomes Study (ALTOS) and Improving Care of Acute Lung Injury Patients (ICAP) Study, two longitudinal cohorts with a total of 823 survivors from 44 US hospitals, which prospectively assessed survivors at 6 and 12 months after ARDS. Perceived health, evaluated using the EQ-5D-VAS, was predicted using ridge regression and self-reported measures of physical, emotional, and social functioning. The difference between observed and predicted perceived health was termed perspective deviation (PD). Correlations between PD and demographics, comorbidities, and severity of illness were explored.

RESULTS:

The correlation between observed and predicted EQ-5D-VAS scores ranged from 0.68 to 0.73 across the two cohorts and time points. PD ranged from -80 to +34 and was more than the minimum clinically important difference for 52% to 55% of survivors. Neither demographic features, comorbidity, nor severity of illness were correlated strongly with PD, with |r| < 0.25 for all continuous variables in both cohorts and time points. The correlation between PD at 6- and 12-month assessments was weak (ALTOS r = 0.22, P < .001; ICAP r = 0.20, P = .02).

INTERPRETATION:

About half of survivors of ARDS showed clinically important differences in actual perceived health vs predicted perceived health based on self-reported measures of functioning. Survivors of ARDS demographic features, comorbidities, and severity of illness were correlated only weakly with perceived health after controlling for measures of perceived functioning, highlighting the challenge of predicting how individual patients will respond psychologically to new impairments after critical illness.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Survivors Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Chest Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiratory Distress Syndrome / Survivors Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Limits: Adult / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Chest Year: 2022 Document Type: Article