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Predictors of 6-month health utility outcomes in survivors of acute respiratory distress syndrome
  1. Samuel M Brown1,2,3,
  2. Emily Wilson1,2,
  3. Angela P Presson4,
  4. Chong Zhang4,
  5. Victor D Dinglas5,6,
  6. Tom Greene4,
  7. Ramona O Hopkins1,2,7,
  8. Dale M Needham5,6,8
  9. with the National Institutes of Health NHLBI ARDS Network
  1. 1Center for Humanizing Critical Care, Intermountain Healthcare, Murray, Utah, USA
  2. 2Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah, USA
  3. 3Pulmonary and Critical Care, University of Utah School of Medicine, Salt Lake City, Utah, USA
  4. 4Division of Epidemiology, Study Design and Biostatistics Center, University of Utah School of Medicine, Salt Lake City, Utah, USA
  5. 5Outcomes After Critical Illness and Surgery Group, Johns Hopkins University, Baltimore, Maryland, USA
  6. 6Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  7. 7Department of Psychology, Neuroscience Center, Brigham Young University, Provo, Utah, USA
  8. 8Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Dr Samuel M Brown, Shock Trauma Intensive Care Unit, 5121 South Cottonwood Street, Murray UT 84107, USA; Samuel.Brown{at}imail.org

Abstract

Background With improving short-term mortality in acute respiratory distress syndrome (ARDS), understanding and improving quality of life (QOL) outcomes in ARDS survivors is a clinical and research priority. We sought to identify variables associated with QOL, as measured by the EQ-5D health utility score, after ARDS using contemporary data science methods.

Methods Analysis of prospectively acquired baseline variables and 6-month EQ-5D health utility scores for adults with ARDS enrolled in the ARDS Network Long-Term Outcomes Study (ALTOS). Penalised regression identified predictors of health utility, with results validated using 10-fold cross-validation.

Results Among 616 ARDS survivors, several predictors were associated with 6-month EQ-5D utility scores, including two lifestyle factors. Specifically, older age, female sex, Hispanic/Latino ethnicity, current smoking and higher body mass index were associated with lower EQ-5D utilities, while living at home without assistance at baseline and AIDS were associated with higher EQ-5D utilities in ARDS survivors. No acute illness variables were associated with EQ-5D utility.

Conclusions Acute illness variables do not appear to be associated with postdischarge QOL among ARDS survivors. Functional independence and lifestyle factors, such as obesity and tobacco smoking, were associated with worse QOL. Future analyses of postdischarge health utility among ARDS survivors should incorporate measures of demographics and functional independence at baseline.

Trial registration numbers NCT00719446 (ALTOS), NCT00434993 (ALTA), NCT00609180 (EDEN/OMEGA), and NCT00883948 (EDEN); Post-results.

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