Health-Related Quality of Life in Australasian Survivors of H1N1 Influenza Undergoing Mechanical Ventilation. A Multicenter Cohort Study

Ann Am Thorac Soc. 2015 Jun;12(6):895-903. doi: 10.1513/AnnalsATS.201412-568OC.

Abstract

Rationale: Patients surviving acute respiratory distress syndrome suffer decrements in physical function and health-related quality of life (HR-QoL); however, it is unclear whether HR-QoL is disproportionately affected in those with H1N1 influenza.

Objectives: The objective was to compare the HR-QoL of patients with a diagnosis of H1N1 influenza who were mechanically ventilated, 12 months after intensive care unit (ICU) discharge with healthy population data and ICU survivor data.

Methods: A prospective, observational, binational, multicenter cohort study was conducted in 11 ICUs in Australia and New Zealand during June-September 2009. Eligible participants were mechanically ventilated in the ICU with a confirmed diagnosis of H1N1 influenza. People were excluded if they were less than 18 years of age or could not speak English. Two validated HR-QoL questionnaires (Short Form-36 version 2 [SF-36], and Assessment of Quality of Life [AQoL]) were administered 1 year after ICU discharge.

Measurements and main results: Sixty-two patients (48% male) had a median (interquartile range) age of 42 (29-53) years and an APACHE II score of 18.0 (14-20); ventilation days, 10.0 (4-23); and ICU and hospital length of stay, 12.5 (7-27) and 20.0 (15-38) days, respectively. Hospital mortality was 7%, and 31% of the cohort received a tracheostomy. The mean (SD) health utility score at 1 year was 0.68 (0.30) compared with the healthy age-matched population (0.81 [0.23]). The mean (SD) SF-36 physical and mental component summary scores were within population normal ranges at 44.4 (12.3) and 45.5 (12.5), respectively.

Conclusions: Health-related quality of life of Australasian survivors of severe H1N1 influenza was comparable to the healthy population 1 year after ICU discharge. Consensus should be sought on standardization of follow-up time points and outcome measurement. Clinical trial registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12609001037291).

Keywords: acute respiratory distress syndrome; influenza; intensive care unit; mechanical ventilation; quality of life.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Australia / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Influenza A Virus, H1N1 Subtype / isolation & purification*
  • Influenza, Human* / complications
  • Influenza, Human* / diagnosis
  • Influenza, Human* / epidemiology
  • Influenza, Human* / physiopathology
  • Influenza, Human* / virology
  • Male
  • Middle Aged
  • New Zealand / epidemiology
  • Outcome Assessment, Health Care
  • Quality of Life*
  • Respiration, Artificial / methods
  • Respiratory Distress Syndrome* / diagnosis
  • Respiratory Distress Syndrome* / epidemiology
  • Respiratory Distress Syndrome* / etiology
  • Respiratory Distress Syndrome* / therapy
  • Surveys and Questionnaires
  • Survivors / psychology*

Associated data

  • ANZCTR/ACTRN12609001037291