Brown Samuel M, Wilson Emily, Presson Angela P, Zhang Chong, Dinglas Victor D, Greene Tom, Hopkins Ramona O, Needham Dale M
Center for Humanizing Critical Care, Intermountain Healthcare, Murray, Utah, USA.
Department of Medicine, Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah, USA.
Thorax. 2017 Apr;72(4):311-317. doi: 10.1136/thoraxjnl-2016-208560. Epub 2016 Jul 20.
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.
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.
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.
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.
NCT00719446 (ALTOS), NCT00434993 (ALTA), NCT00609180 (EDEN/OMEGA), and NCT00883948 (EDEN); Post-results.
随着急性呼吸窘迫综合征（ARDS）患者短期死亡率的改善，了解并改善ARDS幸存者的生活质量（QOL）结果成为临床和研究的重点。我们试图使用当代数据科学方法，确定与ARDS后QOL相关的变量，QOL通过EQ-5D健康效用评分来衡量。
对参加ARDS网络长期结局研究（ALTOS）的ARDS成年患者的前瞻性收集的基线变量和6个月的EQ-5D健康效用评分进行分析。惩罚回归确定健康效用的预测因素，并使用10倍交叉验证对结果进行验证。
在616名ARDS幸存者中，包括两个生活方式因素在内的几个预测因素与6个月的EQ-5D效用评分相关。具体而言，年龄较大、女性、西班牙裔/拉丁裔种族、当前吸烟以及较高的体重指数与较低的EQ-5D效用相关，而基线时在家中无协助生活以及艾滋病与ARDS幸存者较高的EQ-5D效用相关。没有急性疾病变量与EQ-5D效用相关。
急性疾病变量似乎与ARDS幸存者出院后的QOL无关。功能独立性和生活方式因素，如肥胖和吸烟，与较差的QOL相关。未来对ARDS幸存者出院后健康效用的分析应纳入基线时的人口统计学和功能独立性测量。
NCT00719446（ALTOS）、NCT00434993（ALTA）、NCT00609180（EDEN/OMEGA）和NCT00883948（EDEN）；结果后。
