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Critical Care

Open Access

Changes of health-related quality of life in survivors of acute respiratory distress syndrome

  • M Wehler1,
  • A Geise1,
  • D Hadziomerovic1,
  • U Reulbach2,
  • EG Hahn1 and
  • R Strauss1
Critical Care20037(Suppl 2):P257

Published: 3 March 2003


Intensive Care UnitAcute Respiratory Distress SyndromeIntensive Care Unit AdmissionChange ScoreIntensive Care Unit Stay


Few studies have analyzed health-related quality of life (HRQOL) in survivors of acute respiratory distress syndrome (ARDS) taking prehospitalization baseline data into account.

Patients and methods

From June 1997 to May 1999, all admissions (≥ 18 years) to our medical intensive care unit (ICU), an academic referral center, who developed ARDS according to the American-European Consensus Conference definition were eligible. Baseline HRQOL measures were collected by interview during the first 24 hours of the ICU stay and 6 months after admission using a HRQOL questionnaire specifically designed for critically ill patients [1]. A clinically relevant change score was determined by survivors ratings of global health change since ICU admission.


The 265 enrolled patients had a mean age of 59 ± 16 (± SD) years, median 62 years; 58% were male. The mean ICU length of stay was 19 ± 23 days, median 11 days; the mean APACHE II score after 24 hours was 27 ± 9, mean time requiring mechanical ventilation was 17 ± 22 days, median 9 days. The most prevalent predisposing conditions for ARDS were pneumonia and severe sepsis. Cumulative mortality rates were 51% in the ICU, 59% in the hospital, and 65% at 6 months followup. At followup, HRQOL data could be obtained in 87 ARDS survivors; six patients were lost to followup. A change score of -15% was considered as a relevant deterioration using survivors ratings of health transition. Compared with baseline data, a relevant deterioration of HRQOL was reported by 18 (21%) patients in the domain basic physiologic activities, by 31 (35%) patients in the domain activities of daily life, and by 29 (33%) patients in the mental health domain. The majority of the survivors (84%) were living at home and 76% of those previously in employment had returned to their former work. Eighty-one survivors (93%) reported that they would be willing to undergo intensive care again if medically necessary in the future.


Compared with prehospitalization HRQOL, about one-third of our ARDS survivors reported a relevant deterioration in various HRQOL domains. Satisfaction with care and the return-to-work rate was high in our sample of medical ARDS survivors.

Authors’ Affiliations

Department of Medicine I, Biometry and Epidemiology, University Erlangen-Nuremberg, Germany
Department of Medical Informatics, Biometry and Epidemiology, University Erlangen-Nuremberg, Germany


  1. Fernandez RR, et al.: Intensive Care Med 1996, 22: 1034. 10.1007/s001340050209View ArticlePubMedGoogle Scholar


© BioMed Central Ltd 2003