Intensive Care Medicine

, Volume 32, Issue 8, pp 1115–1124 | Cite as

Quality of life after acute respiratory distress syndrome: a meta-analysis

  • David W. Dowdy
  • Mark P. Eid
  • Cheryl R. Dennison
  • Pedro A. Mendez-Tellez
  • Margaret S. Herridge
  • Eliseo Guallar
  • Peter J. Pronovost
  • Dale M. Needham
Systematic Review
First Online:
Received:
Accepted:

Abstract

Objective

To summarize long-term quality of life (QOL) and the degree of variation in QOL estimates across studies of acute respiratory distress (ARDS) survivors.

Design

A systematic review of studies evaluating QOL in ARDS survivors was conducted. Medline, EMBASE, CINAHL, pre-CINAHL, and the Cochrane Library were searched, and reference lists from relevant articles were evaluated. Two authors independently selected studies reporting QOL in adult survivors of ARDS or acute lung injury at least 30 days after intensive care unit discharge and extracted data on study design, patient characteristics, methods, and results.

Measurements and results

Thirteen independent observational studies (557 patients) met inclusion criteria. Eight of these studies used eight different QOL instruments, allowing only qualitative synthesis of results. The five remaining studies (330 patients) measured QOL using the Medical Outcomes Study 36-Item Short Form survey (SF-36). Mean QOL scores were similar across these studies, falling within a range of 20 points for all domains. Pooled domain-specific QOL scores in ARDS survivors 6 months or later after discharge ranged from 45 (role physical) to 66 (social functioning), or 15–26 points lower than population norms, in all domains except mental health (11 points) and role physical (39 points). Corresponding confidence intervals were no wider than ± 9 points. Six studies all found stable or improved QOL over time, but only one found significant improvement beyond 6 months after discharge.

Conclusions

ARDS survivors in different clinical settings experience similar decrements in QOL. The precise magnitude of these decrements helps clarify the long-term prognosis for ARDS survivors.

Keywords

Respiratory distress syndrome, adult Quality of life Critical illness Intensive care units Critical care Outcome assessment (health care) 
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Notes

Acknowledgements

We thank Ramona Hopkins, PhD, and Gustav Schelling, MD, for providing data for use in this review.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • David W. Dowdy
    • 1
    • 2
  • Mark P. Eid
    • 2
  • Cheryl R. Dennison
    • 3
  • Pedro A. Mendez-Tellez
    • 4
  • Margaret S. Herridge
    • 5
  • Eliseo Guallar
    • 1
  • Peter J. Pronovost
    • 3
    • 4
    • 6
    • 7
  • Dale M. Needham
    • 8
  1. 1.Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  2. 2.School of MedicineJohns Hopkins UniversityBaltimoreUSA
  3. 3.School of NursingJohns Hopkins UniversityBaltimoreUSA
  4. 4.Department of Anesthesiology/Critical Care MedicineJohns Hopkins UniversityBaltimoreUSA
  5. 5.Interdepartmental Division of Critical Care MedicineUniversity of TorontoTorontoCanada
  6. 6.Department of SurgeryJohns Hopkins UniversityBaltimoreUSA
  7. 7.Department of Health Policy and ManagementJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  8. 8.Division of Pulmonary/Critical Care MedicineJohns Hopkins UniversityBaltimoreUSA

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