PURPOSE: Data on long term disability from acute lung injury (ALI) come from a follow up of patients enrolled into clinical trials of established ALI with possible selection bias. To determine disability attributable to ALI we compared the long-term survival and functional status between community patients at high risk for ALI who did and who did not develop ALI.
METHODS: Using a nested case control study design in a population-based cohort, we compared outcomes between ALI cases and high risk for ALI controls matched by age, gender and the probability of developing ALI at the time of hospital admission. ALI cases were identified by prospective electronic syndrome surveillance according to standard consensus definition. Functional status was accessed through Barthel Index that was collected at consent time (baseline, pre-illness) and at 6 months after hospital discharge (phone survey).
RESULTS: Of 306 eligible patients, 68 were consented in the hospital and had baseline functional status collected (25 ALI, 43 no ALI). Median age was 60 (IQR 48-72), 46% were female and 91% Caucasians. At 6 months of follow up, 17 patients died (8 (32%) ALI, 9 (21%) no ALI, p=0.31) and 4 (6%) patients were lost to follow up. 47 patients (16 ALI, 31 no ALI) completed the six-month follow up survey. Barthel index at 6 months comparing to baseline was not significantly different comparing patients with ALI (Barthel at baseline 76/100, at 6 months 81/100) with patients at high risk who did not develop ALI (Barthel at baseline 83/100, at 6 months 87/100) (p=0.73).
CONCLUSIONS: In a pilot population based sample patients at risk with or without ALI who survived 6 months after hospital discharge had a similar return of baseline functional status.
CLINICAL IMPLICATIONS: This preliminary study suggests that survivors of ALI in the community have similar functional outcome to patients at risk that did not develop ALI.
DISCLOSURE: The following authors have nothing to disclose: Michelle Biehl, Martin Reriani, Rahul Kashyap, Guangxi Li, Ognjen Gajic
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