Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD.
Chest. 2020 Sep;158(3):999-1007. doi: 10.1016/j.chest.2020.03.059. Epub 2020 Apr 15.
Fatigue is commonly reported by ARDS survivors, but empirical data are scarce.
This study evaluated fatigue prevalence and associated variables in a prospective study of ARDS survivors.
This analysis is part of the ARDSNet Long-Term Outcomes Study (ALTOS) conducted at 38 US hospitals. Using age- and sex-adjusted, time-averaged random effects regression models, we evaluated associations between the validated Functional Assessment of Chronic Illness Therapy-Fatigue Scale with patient and critical illness variables, and with physical, cognitive, and mental health status at 6 and 12 months following ARDS.
Among ARDS survivors, 501 of 711 (70%) and 436 of 659 (66%) reported clinically significant symptoms of fatigue at 6 and 12 months, respectively, with 41% and 28% reporting clinically important improvement and worsening (n = 638). At 6 months, the prevalence of fatigue (70%) was greater than that of impaired physical functioning (50%), anxiety (42%), and depression (36%); 46% reported both impaired physical function and fatigue, and 27% reported co-existing anxiety, depression, and fatigue. Fatigue was less severe in men and in those employed prior to ARDS. Critical illness variables (eg, illness severity, length of stay) had little association with fatigue symptoms. Worse physical, cognitive, and mental health symptoms were associated with greater fatigue at both the 6- and 12-month follow-up.
During the first year following ARDS, more than two-thirds of survivors reported clinically significant fatigue symptoms. Due to frequent co-occurrence, clinicians should evaluate and manage survivors' physical, cognitive, and mental health status when fatigue is endorsed.
ARDS 幸存者常报告疲劳，但实证数据有限。
本研究通过前瞻性 ARDS 幸存者研究评估疲劳的流行率及其相关变量。
该分析是 ARDSNet 长期结果研究（ALTOS）的一部分，在美国 38 家医院进行。使用年龄和性别调整、时间平均随机效应回归模型，我们评估了经过验证的慢性疾病治疗-疲劳量表的功能评估与患者和重症疾病变量之间的关联，以及与 ARDS 后 6 个月和 12 个月的身体、认知和心理健康状况之间的关联。
在 ARDS 幸存者中，分别有 501/711（70%）和 436/659（66%）在 6 个月和 12 个月时报告有临床意义的疲劳症状，分别有 41%和 28%报告有临床意义的改善和恶化（n=638）。在 6 个月时，疲劳的患病率（70%）高于身体功能障碍（50%）、焦虑（42%）和抑郁（36%）；46%的人报告同时存在身体功能障碍和疲劳，27%的人报告同时存在焦虑、抑郁和疲劳。男性和 ARDS 前有工作的患者疲劳程度较轻。重症疾病变量（例如疾病严重程度、住院时间）与疲劳症状相关性较小。身体、认知和心理健康症状越差，与 6 个月和 12 个月随访时的疲劳程度越大。
在 ARDS 发生后的第一年，超过三分之二的幸存者报告有临床意义的疲劳症状。由于经常同时发生，当疲劳被报告时，临床医生应评估和管理幸存者的身体、认知和心理健康状况。
