Objective To inform selection of physical measures for studies of acute respiratory distress syndrome (ARDS) survivors within 12 months of ARDS.
Methods Secondary analysis of data from 6-month survivors participating in a US multicentre prospective study (ARDSNet Long-Term Outcome Study, N=134) or a multisite prospective study in Baltimore, Maryland, USA (Improving Care of Acute Lung Injury Patients, N=99). Physical measures, assessed at 6-month follow-up, were categorised according to the WHO's International Classification of Disability and Health: body functions and structures, activity and participation. Patient-centred outcomes were evaluated at 6 and 12 months: survival, hospitalisation, alive at home status and health-related quality of life. Pearson correlation, linear and logistic regression models were used to quantify associations of physical measures with patient-centred outcomes.
Main results No 6-month body functions and structures measure demonstrated consistent association with 6-month or 12-month outcomes in multivariable regression. The 6 min walk test, an activity measure, was associated with 6-month Short-Form 36 (SF-36) physical component scores (PCS, β range: 0.99 to 1.52, p<0.05). Participation measures (Functional Performance Inventory, FPI; Instrumental Activities of Daily Living, IADLs) were associated with SF-36 PCS (β range: FPI, 1.51–1.52; IADL, −1.88 to −1.32; all p<0.05) and Euro-QOL-5D utility score (β range: FPI, 2.00–3.67; IADL, −2.89 to −2.50; all p<0.01) at 6 and 12 months.
Conclusions Participation measures better reflect patient's quality of life than measures of body functions and structures within 12 months of ARDS among 6-month survivors, and are recommended for inclusion as a core measure in future studies.
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Contributors KSC and DMN contributed to study conception and design. VDD, CLH, CS, PEM, PAM-T, JCJ, ROH and DMN contributed data for the study. LAF conducted analyses, and all authors contributed to analysis and interpretation. KSC drafted the manuscript, and all other authors critically revised it for important intellectual content. All authors approved the submitted manuscript. KSC and DMN are responsible for the overall content and affirm that the manuscript is an accurate account of the reported study and that no important aspects of the study have been omitted.
Funding This research was supported by the National Heart, Lung and Blood Institute (R24 HL111895, R01HL091760, R01HL091760-02S1, R01HL096504, R01HL88045 and P050HL73994), the Johns Hopkins Institute for Clinical and Translational Research (UL1 TR 000424-06), and the ALTA and EDEN/OMEGA trials (contracts for sites participating in this study: HSN268200536170C, HHSN268200536171C, HHSN268200536173C, HHSN268200536174C, HSN268200536175C and HHSN268200536179C).
Competing interests None declared.
Ethics approval Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.
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