Intensive Care Medicine

, Volume 43, Issue 7, pp 980–991 | Cite as

Healthcare utilization and costs in ARDS survivors: a 1-year longitudinal national US multicenter study

  • A. Parker Ruhl
  • Minxuan Huang
  • Elizabeth Colantuoni
  • Taruja Karmarkar
  • Victor D. Dinglas
  • Ramona O. Hopkins
  • Dale M. Needham
  • With the National Institutes of Health, National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network



To evaluate (1) post-discharge healthcare utilization and estimated costs in ARDS survivors, and (2) the association between patient and intensive care-related variables, and 6-month patient status, with subsequent hospitalization and costs.


Longitudinal cohort study enrolling from four ARDSNet trials in 44 US hospitals. Healthcare utilization was collected via structured interviews at 6 and 12 months post-ARDS, and hospital costs estimated via the Medical Expenditure Panel Survey. Adjusted odds ratios for hospitalization and adjusted relative medians for hospital costs were calculated using marginal two-part regression models.


Of 859 consenting survivors, 839 (98%) reported healthcare utilization, with 52% female and a mean age of 49 years old. Over 12 months, 339 (40%) patients reported at least one post-discharge hospitalization, with median estimated hospital costs of US$18,756 (interquartile range $7852–46,174; 90th percentile $101,500). Of 16 patient baseline and ICU variables evaluated, only cardiovascular comorbidity and length of stay were associated with hospitalization, and sepsis was associated with hospital costs. At 6-month assessment, better patient-reported physical activity and quality of life status were associated with fewer hospitalizations and lower hospital costs during subsequent follow-up, and worse psychiatric symptoms were associated with increased hospitalizations.


This multicenter longitudinal study found that 40% of ARDS survivors reported at least one post-discharge hospitalization during 12-month follow-up. Few patient- or ICU-related variables were associated with hospitalization; however, physical, psychiatric, and quality of life measures at 6-month follow-up were associated with subsequent hospitalization. Interventions to reduce post-ARDS morbidity may be important to improve patient outcomes and reduce healthcare utilization.


Patient readmission Healthcare Cost Quality of life Critical illness 



We thank all of the patients and their proxies who participated in this study. We thank Caroline Chessare, Mardee Merrill, Mariela Pinedo, Kyle Schneck, Stacey Schoonmaker, Kristin Sepulveda, Marcella Shrout, Cassie Wicken, Melissa McCullough, Jonathan Gellar, Elizabeth Vayda, Gita Byraiah, Laura Methvin, Vanessa Stan, Shirani Rajan, Cassie Wicken, Meg Shanahan, Elizabeth Baer, and Anita Chandra who assisted with data collection; and Lin Chen, William Flickinger, and Christopher Mayhew who assisted with data management.

Investigators and research staff from National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network sites that participated in this follow-up study: University of Washington, Harborview (*L. Hudson, S. Gundel, C. Hough, M. Neff, K. Sims, A. Ungar, T. Watkins); Providence-Everett Medical Center (S. Lubatti, T.Ziedalski); Baystate Medical Center (*J. Steingrub, M. Tidswell, E. Braden, L. DeSouza, C. Kardos, L. Kozikowski, S. Ouellette); Baylor College of Medicine (K. Guntupalli, V. Bandi, C. Pope, C. Ross); Johns Hopkins University (*R. Brower, H. Fessler, D. Hager, P. Mendez-Tellez, D. Needham, K. Oakjones); Johns Hopkins Bayview Medical Center (J. Sevransky, A. Workneh); University of Maryland (C. Shanholtz, D. Herr, H. Howes, G. Netzer, P. Rock, A. Sampaio, J. Titus); Union Memorial Hospital (P. Sloane, T. Beck, D. Highfield, S. King); Washington Hospital Center (B. Lee, N. Bolouri); Franklin Memorial Hospital Center (S. Selinger, S King); St Josephs Hospital of Baltimore (L Barr); Cleveland Clinic Foundation (*H.P. Wiedemann, R.W. Ashton, D.A. Culver, T. Frederick, J.A. Guzman, J.J. Komara Jr, A.J. Reddy); University Hospitals of Cleveland (R. Hejal, M. Andrews, D. Haney); MetroHealth Medical Center (A.F. Connors, S. Lasalvia, J.D. Thornton, E.L. Warren); University of Colorado Hospital, Aurora (*M. Moss, E.L. Burnham, L. Gray, J. Maloney, M. Mealer); Denver Health Medical Center (I. Douglas, K. Overdier, K. Thompson, R. Wolken); Rose Medical Center (S. Frankel, J. McKeehan); Swedish Medical Center (M.L. Warner); Saint Anthony’s Hospital (T. Bost, C. Higgins, K. Hodgin); Duke University (*N. MacIntyre, L. Brown, C. Cox, M. Gentile, J. Govert, N. Knudsen); University of North Carolina (S. Carson, L. Chang, S. Choudhury, W. Hall, J. Lanier); Vanderbilt University (*A.P. Wheeler, G.R. Bernard, M. Hays, S. Mogan, T.W. Rice); Wake Forest University (*R.D. Hite, A. Harvey, P.E. Morris, Mary Ragusky); Moses Cone Memorial Hospital (P. Wright, S. Groce, J. McLean, A. Overton); University of Virginia (J. Truwit, K. Enfield, M. Marshall); Intermountain Medical Center (*A. Morris, *C. Grissom, A. Austin, S. Barney, S. Brown, J. Ferguson, H. Gallo, T. Graydon, E. Hirshberg, A. Jephson, N. Kumar, M. Lanspa, R. Miller, D. Murphy, J. Orme, A. Stowe, L. Struck, F. Thomas, D. Ward,); LDS Hospital (P. Bailey, W. Beninati, L. Bezdjian, T. Clemmer, S. Rimkus, R. Tanaka, L. Weaver); McKay Dee Hospital (C. Lawton, D. Hanselman); Utah Valley Regional Medical Center (K. Sundar, W. Alward, C. Bishop, D. Eckley, D. Harris, T. Hill, B. Jensen, K. Ludwig, D. Nielsen, M. Pearce); University of California, San Francisco (*M.A. Matthay, C. Calfee, B. Daniel, M. Eisner, O. Garcia, K. Kordesch, K. Liu, N. Shum, H. Zhou); University of California, San Francisco, Fresno (M.W. Peterson, J. Blaauw, K. Van Gundy); San Francisco General Hospital (R. Kallet, E. Johnson); University of California, Davis (T. Albertson, B. Morrissey, E. Vlastelin); Stanford (J. Levitt, E. Kovoor, R. Vojnik); Louisiana State University Health Sciences Center-New Orleans (*B. deBoisblanc, A. Antoine, D. Charbonnet, J. Hunt, P. Lauto, A. Marr, G. Meyaski, C. Romaine); Earl K. Long Medical Center (S. Brierre, J. Byrne, T. Jagneaux, C. LeBlanc, K. Moreau, C. Thomas); Ochsner Clinic Foundation (S. Jain, D. Taylor, L. Seoane); Our Lady of the Lake Medical Center (C. Hebert, J. Thompson); Tulane Medical Center (F. Simeone, J. Fearon).

Clinical Coordinating Center: Massachusetts General Hospital and Harvard Medical School (*D. Schoenfeld, N. Dong, M. Guha, E. Hammond, P. Lazar, R. Morse, C. Oldmixon, N. Ringwood, E. Smoot, B.T. Thompson, R. Wilson).

National Heart, Lung, and Blood Institute: A. Harabin, S. Bredow, M. Waclawiw, G. Weinmann.

Data and Safety Monitoring Board: R. G. Spragg (chair), A. Slutsky, M. Levy, B. Markovitz, E. Petkova, C. Weijer.

Protocol Review Committee: J. Sznajder (chair), M. Begg, L. Gilbert-McClain E. Israel, J. Lewis, S. McClave, P. Parsons. *Principal investigator.

Author contribution

All authors meet the criteria for authorship based on the International Committee of Medical Journal Editors (ICMJE) criteria.

Compliance with ethical standards

Conflicts of interest

All authors declare that they have no conflict of interest to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


National Heart, Lung, and Blood Institute funded this follow-up study (N01HR56170, R01HL091760 and 3R01HL091760-02S1) and the ARDS Network trials (contracts HHSN268200536165C to HHSN268200536176C and HHSN268200536179C). The funder played no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and the decision to submit the manuscript for publication.

Trial registration

These ARDS Network trials are registered with (NCT00434993, NCT00609180, NCT00609180 and NCT00883948, NCT00979121, NCT00719446).

Supplementary material

134_2017_4827_MOESM1_ESM.pdf (185 kb)
Supplementary material 1 (PDF 186 kb)


  1. 1.
    Cheung AM, Tansey CM, Tomlinson G, Diaz-Granados N, Matte A, Barr A, Mehta S, Mazer CD, Guest CB, Stewart TE, Al-Saidi F, Cooper AB, Cook D, Slutsky AS, Herridge MS (2006) Two-year outcomes, health care use, and costs of survivors of acute respiratory distress syndrome. Am J Respir Crit Care Med 174:538–544CrossRefPubMedGoogle Scholar
  2. 2.
    Herridge MS, Tansey CM, Matte A, Tomlinson G, Diaz-Granados N, Cooper A, Guest CB, Mazer CD, Mehta S, Stewart TE, Kudlow P, Cook D, Slutsky AS, Cheung AM (2011) Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 364:1293–1304CrossRefPubMedGoogle Scholar
  3. 3.
    Lone NI, Gillies MA, Haddow C, Dobbie R, Rowan KM, Wild SH, Murray GD, Walsh TS (2016) Five-year mortality and hospital costs associated with surviving intensive care. Am J Respir Crit Care Med 194:198–208CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Needham DM, Dinglas VD, Morris PE, Jackson JC, Hough CL, Mendez-Tellez PA, Wozniak AW, Colantuoni E, Ely EW, Rice TW, Hopkins RO, NIH NHLBI ARDS Network (2013) Physical and cognitive performance of patients with acute lung injury 1 year after initial trophic versus full enteral feeding. EDEN trial follow-up. Am J Respir Crit Care Med 188:567–576CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Huang M, Parker AM, Bienvenu OJ, Dinglas VD, Colantuoni E, Hopkins RO, Needham DM, National Institutes of Health National Heart, Lung, Blood Institute Acute Respiratory Distress Syndrome Network (2016) Psychiatric symptoms in acute respiratory distress syndrome survivors: a 1-year national multicenter study. Crit Care Med 44:954–965CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Fan E, Dowdy DW, Colantuoni E, Mendez-Tellez PA, Sevransky JE, Shanholtz C, Himmelfarb CR, Desai SV, Ciesla N, Herridge MS, Pronovost PJ, Needham DM (2014) Physical complications in acute lung injury survivors: a two-year longitudinal prospective study. Crit Care Med 42:849–859CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Marti J, Hall P, Hamilton P, Lamb S, McCabe C, Lall R, Darbyshire J, Young D, Hulme C (2016) One-year resource utilisation, costs and quality of life in patients with acute respiratory distress syndrome (ARDS): secondary analysis of a randomised controlled trial. J Intensive Care 4:56CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Clermont G, Kong L, Weissfeld LA, Lave JR, Rubenfeld GD, Roberts MS, Connors AF Jr, Bernard GR, Thompson BT, Wheeler AP, Angus DC, NHLBI ARDS Clinical Trials Network (2011) The effect of pulmonary artery catheter use on costs and long-term outcomes of acute lung injury. PLoS One 6:e22512CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Ruhl AP, Huang M, Colantuoni E, Lord RK, Dinglas VD, Chong A, Sepulveda KA, Mendez-Tellez PA, Shanholtz CB, Steinwachs DM, Pronovost PJ, Needham DM (2017) Healthcare resource use and costs in long-term survivors of acute respiratory distress syndrome: a 5-year longitudinal cohort study. Crit Care Med 45:196–204CrossRefPubMedGoogle Scholar
  10. 10.
    Lone NI, Seretny M, Wild SH, Rowan KM, Murray GD, Walsh TS (2013) Surviving intensive care: a systematic review of healthcare resource use after hospital discharge. Crit Care Med 41:1832–1843CrossRefPubMedGoogle Scholar
  11. 11.
    Matthay MA, Brower RG, Carson S, Douglas IS, Eisner M, Hite D, Holets S, Kallet RH, Liu KD, MacIntyre N, Moss M, Schoenfeld D, Steingrub J, Thompson BT (2011) Randomized, placebo-controlled clinical trial of an aerosolized beta(2)-agonist for treatment of acute lung injury. Am J Respir Crit Care Med 184:561–568CrossRefPubMedGoogle Scholar
  12. 12.
    Rice TW, Wheeler AP, Thompson BT, Steingrub J, Hite RD, Moss M, Morris A, Dong N, Rock P (2012) Initial trophic vs full enteral feeding in patients with acute lung injury: the EDEN randomized trial. JAMA 307:795–803CrossRefPubMedGoogle Scholar
  13. 13.
    Rice TW, Wheeler AP, Thompson BT, deBoisblanc BP, Steingrub J, Rock P (2011) Enteral omega-3 fatty acid, gamma-linolenic acid, and antioxidant supplementation in acute lung injury. JAMA 306:1574–1581CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    National Heart, Lung, and Blood Institute ARDS Clinical Trials Network, Truwit JD, Bernard GR, Steingrub J, Matthay MA, Liu KD, Albertson TE, Brower RG, Shanholtz C, Rock P, Douglas IS, deBoisblanc BP, Hough CL, Hite RD, Thompson BT (2014) Rosuvastatin for sepsis-associated acute respiratory distress syndrome. N Engl J Med 370:2191–2200CrossRefGoogle Scholar
  15. 15.
    Needham DM, Colantuoni E, Dinglas VD, Hough CL, Wozniak AW, Jackson JC, Morris PE, Mendez-Tellez PA, Ely EW, Hopkins RO (2016) Rosuvastatin versus placebo for delirium in intensive care and subsequent cognitive impairment in patients with sepsis-associated acute respiratory distress syndrome: an ancillary study to a randomised controlled trial. Lancet Respir Med 4:203–212CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Needham DM, Dinglas VD, Bienvenu OJ, Colantuoni E, Wozniak A, Rice TW, Hopkins RO (2013) One year outcomes of initial trophic vs full enteral feeding in acute lung injury patients: prospective follow-up ofthe EDEN randomized trial. BMJ 346:f1532CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Needham DM, Dinglas VD, Morris PE, Jackson JC, Hough CL, Mendez-Tellez PA, Wozniak AW, Colantuoni E, Ely EW, Rice TW, Hopkins RO (2013) Physical and cognitive performance of patients with acute lung injury 1 year after initial trophic versus full enteral feeding. EDEN trial follow-up. Am J Respir Crit Care Med 188:567–576CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Dinglas VD, Hopkins RO, Wozniak AW, Hough CL, Morris PE, Jackson JC, Mendez-Tellez PA, Bienvenu OJ, Ely EW, Colantuoni E, Needham DM (2016) One-year outcomes of rosuvastatin versus placebo in sepsis-associated acute respiratory distress syndrome: prospective follow-up of SAILS randomised trial. Thorax 71:401–410CrossRefPubMedGoogle Scholar
  19. 19.
    Leidy NK, Knebel A (1999) Clinical validation of the functional performance inventory in patients with chronic obstructive pulmonary disease. Respir Care 44:932–939Google Scholar
  20. 20.
    Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370CrossRefPubMedGoogle Scholar
  21. 21.
    Bienvenu OJ, Williams JB, Yang A, Hopkins RO, Needham DM (2013) Posttraumatic stress disorder in survivors of acute lung injury: evaluating the impact of Event Scale-Revised. Chest 144:24–31CrossRefPubMedGoogle Scholar
  22. 22.
    Newkirk LA, Kim JM, Thompson JM, Tinklenberg JR, Yesavage JA, Taylor JL (2004) Validation of a 26-point telephone version of the Mini-Mental State Examination. J Geriatr Psychiatry Neurol 17:81–87CrossRefPubMedGoogle Scholar
  23. 23.
    Group TE (1990) EuroQol–a new facility for the measurement of health-related quality of life. Health Policy 16:199–208CrossRefGoogle Scholar
  24. 24.
    Ware JE Jr, Kosinski M, Dewey JE (2000) How to score version 2 of the SF-36 health survey. QualityMetric, LincolnGoogle Scholar
  25. 25.
    Walters SJ, Brazier JE (2005) Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual Life Res 14:1523–1532CrossRefPubMedGoogle Scholar
  26. 26.
    Samsa G, Edelman D, Rothman ML, Williams GR, Lipscomb J, Matchar D (1999) Determining clinically important differences in health status measures: a general approach with illustration to the Health Utilities Index Mark II. PharmacoEconomics 15:141–155CrossRefPubMedGoogle Scholar
  27. 27.
    Puhan MA, Frey M, Buchi S, Schunemann HJ (2008) The minimal important difference of the hospital anxiety and depression scale in patients with chronic obstructive pulmonary disease. Health Qual Life Outcomes 6:46CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Norman GR, Sloan JA, Wyrwich KW (2003) Interpretation of changes in health-related quality of life: the remarkable universality of half a standard deviation. Med Care 41:582–592PubMedGoogle Scholar
  29. 29.
    Ruhl AP, Lord RK, Panek JA, Colantuoni E, Sepulveda KA, Chong A, Dinglas VD, Shanholtz CB, Pronovost PJ, Steinwachs DM, Needham DM (2015) Health care resource use and costs of two-year survivors of acute lung injury. An observational cohort study. Ann Am Thorac Soc 12:392–401CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Sirey JA, Meyers BS, Teresi JA, Bruce ML, Ramirez M, Raue PJ, Perlick DA, Holmes D (2005) The Cornell Service Index as a measure of health service use. Psychiatr Serv 56:1564–1569CrossRefPubMedGoogle Scholar
  31. 31.
    Means B (1989) Autobiographical memory for health-related events. No. 2. US Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Center for Health StatisticsGoogle Scholar
  32. 32.
    Coughlan D, Yeh ST, O’Neill C, Frick KD (2014) Evaluating direct medical expenditures estimation methods of adults using the medical expenditure panel survey: an example focusing on head and neck cancer. Value Health 17:90–97CrossRefPubMedGoogle Scholar
  33. 33.
    Diehr P, Yanez D, Ash A, Hornbrook M, Lin DY (1999) Methods for analyzing health care utilization and costs. Annu Rev Public Health 20:125–144CrossRefPubMedGoogle Scholar
  34. 34.
    Fine JG, Gray RJ (1999) A proportional hazards model for the subdistribution of a competing risk. J Am Stat Assoc 94:496–509CrossRefGoogle Scholar
  35. 35.
    Hua M, Gong MN, Brady J, Wunsch H (2015) Early and late unplanned rehospitalizations for survivors of critical illness. Crit Care Med 43:430–438CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Prescott HC, Langa KM, Liu V, Escobar GJ, Iwashyna TJ (2014) Increased 1-year healthcare use in survivors of severe sepsis. Am J Respir Crit Care Med 190:62–69CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Liu V, Lei X, Prescott HC, Kipnis P, Iwashyna TJ, Escobar GJ (2014) Hospital readmission and healthcare utilization following sepsis in community settings. J Hosp Med 9:502–507CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Goodwin AJ, Rice DA, Simpson KN, Ford DW (2015) Frequency, cost, and risk factors of readmissions among severe sepsis survivors. Crit Care Med 43:738–746CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Hu J, Gonsahn MD, Nerenz DR (2014) Socioeconomic status and readmissions: evidence from an urban teaching hospital. Health Aff (Millwood) 33:778–785CrossRefGoogle Scholar
  40. 40.
    Herridge MS, Chu LM, Matte A, Tomlinson G, Chan L, Thomas C, Friedrich JO, Mehta S, Lamontagne F, Levasseur M, Ferguson ND, Adhikari NK, Rudkowski JC, Meggison H, Skrobik Y, Flannery J, Bayley M, Batt J, Dos Santos C, Abbey SE, Tan A, Lo V, Mathur S, Parotto M, Morris D, Flockhart L, Fan E, Lee CM, Wilcox ME, Ayas N, Choong K, Fowler R, Scales DC, Sinuff T, Cuthbertson BH, Rose L, Robles P, Burns S, Cypel M, Singer L, Chaparro C, Chow CW, Keshavjee S, Brochard L, Hebert P, Slutsky AS, Marshall JC, Cook D, Cameron JI, RECOVER Program Investigators (Phase 1: towards RECOVER), Canadian Critical Care Trials Group (2016) The RECOVER program: disability risk groups and one year outcome after ≥7 days of mechanical ventilation. Am J Respir Crit Care Med 194(7):831–844CrossRefPubMedGoogle Scholar
  41. 41.
    Lee H, Doig CJ, Ghali WA, Donaldson C, Johnson D, Manns B (2004) Detailed cost analysis of care for survivors of severe sepsis. Crit Care Med 32:981–985CrossRefPubMedGoogle Scholar
  42. 42.
    Unroe M, Kahn JM, Carson SS, Govert JA, Martinu T, Sathy SJ, Clay AS, Chia J, Gray A, Tulsky JA, Cox CE (2010) One-year trajectories of care and resource utilization for recipients of prolonged mechanical ventilation: a cohort study. Ann Intern Med 153:167–175CrossRefPubMedPubMedCentralGoogle Scholar
  43. 43.
    Hussey PS, Schneider EC, Rudin RS, Fox DS, Lai J, Pollack CE (2014) Continuity and the costs of care for chronic disease. JAMA Intern Med 174:742–748CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Davydow DS, Hough CL, Zatzick D, Katon WJ (2014) Psychiatric symptoms and acute care service utilization over the course of the year following medical-surgical ICU admission: a longitudinal investigation. Crit Care Med 42:2473–2481CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Kjellsson G, Clarke P, Gerdtham UG (2014) Forgetting to remember or remembering to forget: a study of the recall period length in health care survey questions. J Health Econ 35:34–46CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM (outside the USA) 2017

Authors and Affiliations

  • A. Parker Ruhl
    • 1
    • 2
    • 3
  • Minxuan Huang
    • 2
    • 3
  • Elizabeth Colantuoni
    • 2
    • 4
  • Taruja Karmarkar
    • 5
  • Victor D. Dinglas
    • 2
    • 3
  • Ramona O. Hopkins
    • 6
    • 7
    • 8
  • Dale M. Needham
    • 2
    • 3
    • 9
  • With the National Institutes of Health, National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome Network
  1. 1.National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesdaUSA
  2. 2.Outcomes after Critical Illness and Surgery (OACIS) GroupJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Division of Pulmonary and Critical Care MedicineJohns Hopkins University School of MedicineBaltimoreUSA
  4. 4.Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  5. 5.Department of Health Policy and ManagementJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  6. 6.Pulmonary and Critical Care Division, Department of MedicineIntermountain Medical CenterMurrayUSA
  7. 7.Center for Humanizing Critical CareIntermountain HealthcareMurrayUSA
  8. 8.Psychology Department and Neuroscience CenterBrigham Young UniversityProvoUSA
  9. 9.Department of Physical Medicine and RehabilitationJohns Hopkins University School of MedicineBaltimoreUSA

Personalised recommendations