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Two-Year Cognitive, Emotional, and Quality-of-Life Outcomes in Acute Respiratory Distress Syndrome

Department of Medicine, Pulmonary and Critical Care Divisions, and Statistical Data Center, LDS Hospital; University of Utah School of Medicine, Salt Lake City; and Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah; and Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida

Correspondence and requests for reprints should be addressed to Ramona O. Hopkins, Ph.D., Critical Care Medicine, LDS Hospital, Eighth Avenue and C Street, Salt Lake City, UT 84602. Email: ldrhopki{at}ihc.com

Acute respiratory distress syndrome (ARDS) has a high mortality and is associated with significant morbidity. Prior outcome studies have focused predominant on short-term outcomes (6–12 months). We assessed longitudinal neurocognitive, emotional, and quality of life in ARDS survivors at hospital discharge, and 1 and 2 years after hospital discharge using neuropsychologic tests and emotional and quality-of-life questionnaires. Neurocognitive sequelae occurred in 73% (54 of 74) of ARDS survivors at hospital discharge, 46% (30 of 66) at 1 year, and 47% (29 of 62) at 2 years. ARDS survivors report moderate to severe depression (16% and 23%) and anxiety (24% and 23%) at 1 and 2 years, respectively. The ARDS survivors had decreased quality of life, with the physical domains improving at 1 year, with no additional change at 2 years. Role emotional, pain, and general health did not change from hospital discharge to 2 years. Mental health improved during the first year and declined at 2 years. ARDS results in significant neurocognitive and emotional morbidity and decreased quality of life that persists at least 2 years after hospital discharge. ARDS can cause significant long-term, brain-related morbidity manifest by neurocognitive impairments and decreased quality of life.

Key Words: ARDS • cognitive outcome • emotional function • quality of life

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