PURPOSE: Information about quality of life (QOL) among long term survivors of Acute lung injury (ALI) are limited outside clinical trials which include highly selected populations. We aimed to assess the feasibility of long term QOL assessment in a population based cohort of patients with or at risk of ALI in Olmsted County, Minnesota.
METHODS: Previously validated LIPS (lung injury prediction score) was utilized to identify adult Olmstead County residents at increased risk of ALI admitted to Mayo clinic between February 2009 and April 2011. The essential patient-centered outcomes (unadjusted and quality-adjusted survival, neurocognitive, neuropsychologic and neuromuscular complications, functional status, and quality of life) were obtained at baseline and at six months follow-up. Baseline (premorbid) functional status and QOL were determined by in-hospital retrospective survey of the patients or their surrogates. Follow-up contact information was obtained and the patients or their surrogate who successfully completed the baseline survey were contacted by telephone six month after index hospitalization. Screening for ALI development was performed by previously validated electronic surveillance according to standard consensus conference definitions.
RESULTS: 352 patients were eligible for inclusion in the study. 95 patients (26%) successfully completed baseline questionnaires at hospital discharge. Of the 256 patients who did not fill the baseline survey 75 patients (29%) were discharged prior to consent acquisition, 65 (25%) died in the hospital, 46 (18%) refused and 34 (13%) were too ill to answer the questionnaires. Of the 95 patients enrolled in the study 49 (51%) completed a 6 months survey, 23 (24%) died during the 6 months period and 3 (3%) withdraw consent. Twenty two patients (22%) are still in the study.
CONCLUSIONS: Discharge from the hospital prior to consent and mortality (in hospital and post-hospital) are the biggest challenges to assessing long-term patient reported outcomes in population based studies of critically ill patients.
CLINICAL IMPLICATIONS: A population based observational cohort study that aims to identify patients at high risk of developing ALI early in the course of illness can determine the attributable burden of the disease.
DISCLOSURE: The following authors have nothing to disclose: Martin Reriani, Michelle Biehl, Rahul Kashyap, Guangxi Li, Ognjen Gajic
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