Long-term Outcomes Of Patients After Acute Respiratory Distress Syndrome

Objectives: Although short-term survival rates improve among patients with acute respiratory distress syndrome(ARDS),long-term outcomes of ARDS are less studied.The aim of this study was to determine the survival rate of ARDS survivors and to characterize the long-term quality of life of ARDS survivors.We also investigated the factors that affect the long-term prognosis of ARDS patients in order to prevent risk factors and to develop an appropriate management plan in advance.Methods: We assessed the prognosis of 75 acute respiratory distress syndrome survivors at 3,6,12 months,2 years and 3 years after they were discharged from the ICU.A telephone follow-up was conducted by two volunteers.We evaluated the quality of life for ARDS survivors by assessing the motor and psychosocial factors.The motor factors included six minutes walking distance,SF36 score,EQ5 D and functional status score.The psychosocial factors included SF36 score,PTSD and HADS.Results: The survival rates at 3,6,12 months,2 years and 3 years were 90.67%,89.33%,89.33%,88% and 85.33%,respectively.Six minutes walking distance,SF36 score,EQ5 D,functional status score were lowest in the first year,the median and quartile increased in 2 ~ 3 year.Ventilator use time,length of stay in ICU,length of hospitalization and systemic corticosteroid treatmentwere correlated with 6-minute walking distance at 1 year(P <0.05).Nursing place was correlated with 6-minute walking distance at 2~3 years(P <0.05).Survivors often showed a certain degree of anxiety,depression and other psychological disorders,which was the most serious in the first year after they were discharged.The median and interquartile range of HADS and PTSD scores were highest in the first year,and decreased in 2 ~ 3 year.Length of hospitalization wad correlated with HADS and PTSD scores(P <0.001).Conclusions: Survivors of ARDS continued to have physical and mental dysfunction after they were discharged from the hospital.Physical limitations and weakness were the most prominent features,which recovered gradually but were still lower than the normal age group.They also showed varying degrees of emotional disorders.Individualized treatment and rehabilitation protocol should be developed based on the clinical features and severity of the disease.