Hopkins Ramona O, Weaver Lindell K, Collingridge Dave, Parkinson R Bruce, Chan Karen J, Orme James F
Department of Critical Care Medicine, LDS Hospital, Eighth Avenue and C Street, Salt Lake City, UT 84602.
Am J Respir Crit Care Med. 2005 Feb 15;171(4):340-7. doi: 10.1164/rccm.200406-763OC. Epub 2004 Nov 12.
Acute respiratory distress syndrome (ARDS) has a high mortality and is associated with significant morbidity. Prior outcome studies have focused predominant on short-term outcomes (6-12 months). We assessed longitudinal neurocognitive, emotional, and quality of life in ARDS survivors at hospital discharge, and 1 and 2 years after hospital discharge using neuropsychologic tests and emotional and quality-of-life questionnaires. Neurocognitive sequelae occurred in 73% (54 of 74) of ARDS survivors at hospital discharge, 46% (30 of 66) at 1 year, and 47% (29 of 62) at 2 years. ARDS survivors report moderate to severe depression (16% and 23%) and anxiety (24% and 23%) at 1 and 2 years, respectively. The ARDS survivors had decreased quality of life, with the physical domains improving at 1 year, with no additional change at 2 years. Role emotional, pain, and general health did not change from hospital discharge to 2 years. Mental health improved during the first year and declined at 2 years. ARDS results in significant neurocognitive and emotional morbidity and decreased quality of life that persists at least 2 years after hospital discharge. ARDS can cause significant long-term, brain-related morbidity manifest by neurocognitive impairments and decreased quality of life.
急性呼吸窘迫综合征(ARDS)死亡率高,且伴有严重的并发症。既往的结局研究主要集中在短期结局(6 - 12个月)。我们使用神经心理学测试以及情绪和生活质量问卷,评估了ARDS幸存者在出院时、出院后1年和2年的纵向神经认知、情绪和生活质量情况。73%(74例中的54例)的ARDS幸存者在出院时出现神经认知后遗症,1年时为46%(66例中的30例),2年时为47%(62例中的29例)。ARDS幸存者在1年和2年时分别报告有中度至重度抑郁(分别为16%和23%)和焦虑(分别为24%和23%)。ARDS幸存者的生活质量下降,身体领域在1年时有所改善,2年时无进一步变化。从出院到2年,角色情绪、疼痛和总体健康状况没有改变。心理健康在第一年有所改善,在2年时下降。ARDS会导致严重的神经认知和情绪并发症以及生活质量下降,且在出院后至少持续2年。ARDS可导致严重的长期、与脑相关的并发症,表现为神经认知障碍和生活质量下降。