Quality of Life for ARDS Patients More Tied to Lifestyle Factors, Not Severity of Illness

For survivors of acute respiratory distress syndrome (ARDS), poor lifestyle factors — such as obesity and smoking — are more closely tied to a subsequent poorer quality of life rather than the actual severity of their illness, according to a new multi-university study.

ARDS is a progressive condition in which patients have difficulty breathing due to a fluid leak in the lungs. It typically occurs in people who are already critically ill or who have suffered traumatic injuries. Most ARDS patients are unable to breathe on their own without support from a ventilator.

For the study, critical care researchers from Intermountain Medical Center in Salt Lake City evaluated 616 patients who had been treated for ARDS to find out which factors played the most significant role in their quality of life six months following discharge from the hospital.

The findings show that the patient’s acuity, or level of illness, was not a significant marker in their subsequent quality of life, but rather it was lifestyle factors, specifically obesity and smoking, that were tied to a worse quality of life.

Researchers from the National Institutes of Health ARDS Network, Johns Hopkins University, Brigham Young University and the University of Utah School of Medicine, also participated in the study.

With survival rates improving for ARDS patients, understanding and improving their quality of life outcomes is a clinical and research priority, according to the study’s lead researcher Samuel M. Brown, M.D., MS, FASE, director of the Center for Humanizing Critical Care at Intermountain Medical Center.

“The ICU and the critical care environment are so focused on life-and-death issues, and we’re so busy as clinicians, that we often don’t have time to think about lifestyle factors, such as obesity and smoking and the role they play in our patient’s long-term quality of life. Our study emphasizes the need for us to do more of that,” said Brown.

Another significant finding from the study was that patients’ level of acuity in the hospital was not a significant predictor of a poor quality of life after being discharged from the hospital.

“We see patients who we’re treating for ARDS who are very sick and, who at the time, may not look like their quality of life will be great, but our study shows that their level of acuity is not a marker of whether they will experience a high quality of life once they leave the hospital,” said Brown.

“We found that quality of life for ARDS survivors is more influenced by lifestyle choices, such as smoking and obesity.”

Brown added that these findings suggest that smoking cessation education should be incorporated into the critical care setting.

“Evidence from our study, and other evidence, suggests that there is an urgent need to better support these patients who survive ARDS because they’re confronting some difficulties and unique challenges,” said Brown.

Next, the researchers plan to study specific interventions that would benefit vulnerable patients at-risk for a poor quality of life after hospital discharge, he added.

The study findings are published online in the journal Thorax.

Source: Intermountain Medical Center