1 Department of Physiotherapy, Western Health, Footscray, Victoria, Australia.
2 Allied Health Research Unit, Faculty of Medicine Nursing and Health Science, Monash University, Frankston, Victoria, Australia.
Ann Am Thorac Soc. 2015 Jun;12(6):895-903. doi: 10.1513/AnnalsATS.201412-568OC.
Patients surviving acute respiratory distress syndrome suffer decrements in physical function and health-related quality of life (HR-QoL); however, it is unclear whether HR-QoL is disproportionately affected in those with H1N1 influenza.
The objective was to compare the HR-QoL of patients with a diagnosis of H1N1 influenza who were mechanically ventilated, 12 months after intensive care unit (ICU) discharge with healthy population data and ICU survivor data.
A prospective, observational, binational, multicenter cohort study was conducted in 11 ICUs in Australia and New Zealand during June-September 2009. Eligible participants were mechanically ventilated in the ICU with a confirmed diagnosis of H1N1 influenza. People were excluded if they were less than 18 years of age or could not speak English. Two validated HR-QoL questionnaires (Short Form-36 version 2 [SF-36], and Assessment of Quality of Life [AQoL]) were administered 1 year after ICU discharge.
Sixty-two patients (48% male) had a median (interquartile range) age of 42 (29-53) years and an APACHE II score of 18.0 (14-20); ventilation days, 10.0 (4-23); and ICU and hospital length of stay, 12.5 (7-27) and 20.0 (15-38) days, respectively. Hospital mortality was 7%, and 31% of the cohort received a tracheostomy. The mean (SD) health utility score at 1 year was 0.68 (0.30) compared with the healthy age-matched population (0.81 [0.23]). The mean (SD) SF-36 physical and mental component summary scores were within population normal ranges at 44.4 (12.3) and 45.5 (12.5), respectively.
Health-related quality of life of Australasian survivors of severe H1N1 influenza was comparable to the healthy population 1 year after ICU discharge. Consensus should be sought on standardization of follow-up time points and outcome measurement. Clinical trial registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12609001037291).
患有急性呼吸窘迫综合征的患者其身体机能和健康相关生活质量（HR-QoL）均会下降；然而，对于甲型 H1N1 流感患者，HR-QoL 是否会受到不成比例的影响仍不清楚。
本研究旨在比较甲型 H1N1 流感患者机械通气后 12 个月的 HR-QoL 与健康人群数据和重症监护病房（ICU）幸存者数据。
这是一项在澳大利亚和新西兰的 11 个 ICU 中进行的前瞻性、观察性、两国、多中心队列研究。符合条件的参与者在 ICU 中接受了甲型 H1N1 流感确诊的机械通气治疗。如果参与者年龄小于 18 岁或不能说英语，则将其排除在外。在 ICU 出院后 1 年时，使用两种经过验证的 HR-QoL 问卷（36 项简短健康调查问卷 2 版[SF-36]和生活质量评估问卷[AQoL]）进行评估。
共有 62 名患者（48%为男性），年龄中位数（四分位间距）为 42（29-53）岁，急性生理和慢性健康状况评分Ⅱ（APACHEⅡ）为 18.0（14-20）分；通气天数为 10.0（4-23）天；ICU 住院日和住院日分别为 12.5（7-27）天和 20.0（15-38）天。住院死亡率为 7%，31%的患者接受了气管切开术。1 年后的平均（SD）健康效用评分（0.68 [0.30]）与年龄匹配的健康人群（0.81 [0.23]）相比较低。平均（SD）SF-36 生理和心理成分综合评分分别为 44.4（12.3）和 45.5（12.5），均在人群正常范围内。
甲型 H1N1 流感重症患者在 ICU 出院后 1 年的 HR-QoL 与健康人群相当。应就标准化随访时间点和结局测量达成共识。本研究已在澳大利亚和新西兰临床试验注册中心（ACTRN12609001037291）注册。
