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Published ahead of print on November 12, 2004, doi:10.1164/rccm.200406-763OC

Am. J. Respir. Crit. Care Med., Volume 171, Number 4, February 2005, 340-347

A more recent version of this article appeared on February 15, 2005
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Submitted on June 18, 2004
Accepted on November 5, 2004

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

Ramona O Hopkins1*, Lindell K Weaver2, Dave Collingridge3, R. Bruce Parkinson4, Karen J Chan5, and James F Orme, Jr.2

1 Department of Medicine, Pulmonary and Critical Care Divisions, LDS Hospital, Salt Lake City, UT, USA; Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA, 2 Department of Medicine, Pulmonary and Critical Care Divisions, LDS Hospital, Salt Lake City, UT, USA; Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA, 3 Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA, 4 Department of Psychology and Neuroscience Center, Brigham Young University, Provo, UT, USA; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA, 5 Statistical Data Center, LDS Hospital, Salt Lake City, UT, USA

* To whom correspondence should be addressed. E-mail: ramona_hopkins{at}byu.edu.

Acute respiratory distress syndrome (ARDS) has a high mortality and is associated with significant morbidity. Prior outcome studies have focused predominately on short-term outcomes (6 to 12 months). We assessed longitudinal neurocognitive, emotional, and quality of life in ARDS survivors at hospital discharge, and one and two years post-hospital discharge using neuropsychological tests, 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 one year, and 47% (29 of 62) at two years. ARDS survivors report moderate to severe depression (16% and 23%) and anxiety (24% and 23%) at one and two years respectively. The ARDS survivors had decreased quality of life, with the physical domains improving to one year, with no additional change at two years. Role emotional, pain, and general health did not change from hospital discharge to two years. Mental health improved during the first year and declined at two years. ARDS results in significant neurocognitive and emotional morbidity and decreased quality of life that persists at least two years post-hospital discharge. Acute respiratory distress syndrome can cause significant long-term brain-related morbidity manifest by neurocognitive impairments and decreased quality of life.
Key words: ARDS, Quality of life, cognitive outcome, emotional function




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