TY - JOUR
T1 - Health-related quality of life in mechanically ventilated Australasian survivors of H1N1 influenza is comparable to population norms one year following discharge
AU - Skinner, Elizabeth
AU - Haines, Kimberley
AU - Howe, Belinda Duval
AU - Hodgson, Carol Lynette
AU - Denehy, Linda
AU - McArthur, Colin
AU - Seller, Daniel
AU - DiMarco, Emma
AU - Mulvany, Kate
AU - Ryan, Danielle
AU - Berney, Sue
PY - 2014
Y1 - 2014
N2 - Rationale: The H1N1 influenza pandemic of 2009 was a global disaster and the intensive care unit (ICU) course was characterised by
prolonged mechanical ventilation and length of stay (LOS). Previous research conducted in people with acute respiratory distress
syndrome has demonstrated impairments in physical function and health-related quality of life (HR-QoL) which persist up to five years
following ICU admission. Previous Australian data demonstrate that general ICU survivors return to pre-existing HR-QoL however it is
unclear whether HR-QoL is disproportionately affected in patients with H1N1 influenza. The hypothesis was that mechanically ventilated
Australasian adult survivors of H1N1 influenza would have worse HR-QoL than the healthy population one year following ICU discharge.
Methods: A prospective observational cohort study was conducted with institutional review board approval. Eligible participants were
admitted to ICU and mechanically ventilated with a confirmed diagnosis of H1N1 influenza from eleven ICUs in Australia and New Zealand
during the period June-September, 2009. People were excluded if aged <18 years or they could not speak English. Eligible participants
were contacted by letter and informed consent sought via a scripted telephone call. Demographic details were extracted from the
Australian and New Zealand Intensive Care Influenza Investigators registry (INFINITE) and local intensive care databases. Two HR-QoL
questionnaires validated in the ICU population were administered one year following ICU: Short Form-36 Version 2 (SF-36) and the
Assessment of Quality of Life (AQoL).
Results: Sixty-two people were recruited (48 male). The median (IQR) age was 42 (29 to 53) years, APACHE II score was 18.0 (14 to 20);
ventilation days were 10.0 (4 to 23); ICU and hospital LOS was 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 one year was 0.68 (0.30) compared to the healthy
age-matched population mean (SD) of 0.81 (0.23). The mean (SD) physical and mental component summary scores of the SF-36 were with
population normal ranges at 44.4 (12.3) and 45.5 (12.5) respectively. HR-QoL domain scores were within normal ranges. Fourteen percent
of the cohort was lost to follow-up.
Conclusions: This is the first study to measure HR-QoL in Australasian survivors of H1N1 influenza and survivors reported comparable
health-related quality of life to the normal population. However this is likely influenced by survivor bias, response bias and loss to
follow-up.
AB - Rationale: The H1N1 influenza pandemic of 2009 was a global disaster and the intensive care unit (ICU) course was characterised by
prolonged mechanical ventilation and length of stay (LOS). Previous research conducted in people with acute respiratory distress
syndrome has demonstrated impairments in physical function and health-related quality of life (HR-QoL) which persist up to five years
following ICU admission. Previous Australian data demonstrate that general ICU survivors return to pre-existing HR-QoL however it is
unclear whether HR-QoL is disproportionately affected in patients with H1N1 influenza. The hypothesis was that mechanically ventilated
Australasian adult survivors of H1N1 influenza would have worse HR-QoL than the healthy population one year following ICU discharge.
Methods: A prospective observational cohort study was conducted with institutional review board approval. Eligible participants were
admitted to ICU and mechanically ventilated with a confirmed diagnosis of H1N1 influenza from eleven ICUs in Australia and New Zealand
during the period June-September, 2009. People were excluded if aged <18 years or they could not speak English. Eligible participants
were contacted by letter and informed consent sought via a scripted telephone call. Demographic details were extracted from the
Australian and New Zealand Intensive Care Influenza Investigators registry (INFINITE) and local intensive care databases. Two HR-QoL
questionnaires validated in the ICU population were administered one year following ICU: Short Form-36 Version 2 (SF-36) and the
Assessment of Quality of Life (AQoL).
Results: Sixty-two people were recruited (48 male). The median (IQR) age was 42 (29 to 53) years, APACHE II score was 18.0 (14 to 20);
ventilation days were 10.0 (4 to 23); ICU and hospital LOS was 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 one year was 0.68 (0.30) compared to the healthy
age-matched population mean (SD) of 0.81 (0.23). The mean (SD) physical and mental component summary scores of the SF-36 were with
population normal ranges at 44.4 (12.3) and 45.5 (12.5) respectively. HR-QoL domain scores were within normal ranges. Fourteen percent
of the cohort was lost to follow-up.
Conclusions: This is the first study to measure HR-QoL in Australasian survivors of H1N1 influenza and survivors reported comparable
health-related quality of life to the normal population. However this is likely influenced by survivor bias, response bias and loss to
follow-up.
UR - http://www.atsjournals.org/doi/pdf/10.1164/ajrccm-conference.2014.189.1_MeetingAbstracts.A1628
U2 - 10.1164/ajrccm-conference.2014.189.1
DO - 10.1164/ajrccm-conference.2014.189.1
M3 - Letter
SN - 1073-449X
VL - 189
SP - 1628
EP - 1628
JO - American Journal of Respiratory and Critical Care Medicine
JF - American Journal of Respiratory and Critical Care Medicine
ER -