Citation

Bienvenu OJ, Colantuoni E, Mendez-Tellez PA, Dinglas VD, Shanholtz C, Husain N, Dennison CR, Herridge MS, Pronovost PJ, Needham DM. Am. J. Respir. Crit. Care Med. 2011; 185(5): 517-524.

Affiliation

Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.

Copyright

(Copyright © 2011, American Thoracic Society)

DOI

10.1164/rccm.201103-0503OC

PMID

22161158

PMCID

PMC3297105

Abstract

RATIONALE: Survivors of acute lung injury (ALI) frequently have substantial depressive symptoms and physical impairment, but the longitudinal epidemiology of these conditions remains unclear. OBJECTIVES: To evaluate the 2-year incidence and duration of depressive symptoms and physical impairment after ALI, as well as risk factors for these conditions. METHODS: This prospective, longitudinal cohort study recruited patients from 13 intensive care units in 4 hospitals, with follow-up 3, 6, 12, and 24 months after ALI. The outcomes were Hospital Anxiety and Depression Scale depression score ≥8 ("depressive symptoms") in patients without a history of depression prior to ALI, and ≥2 dependencies in instrumental activities of daily living ("impaired physical function") in patients without baseline impairment. MEASUREMENTS AND MAIN RESULTS: During 2-year follow-up of 186 ALI survivors, the cumulative incidences of depressive symptoms and impaired physical function were 40% and 66%, respectively, with greatest incidence by 3-month follow-up; modal durations were >21 months for each outcome. Risk factors for incident depressive symptoms were education ≤12 years, baseline disability or unemployment, higher baseline medical comorbidity, and lower blood glucose in the intensive care unit. Risk factors for incident impaired physical function were longer intensive care unit stay and prior depressive symptoms. CONCLUSIONS: Incident depressive symptoms and impaired physical function are common and long-lasting during the first 2 years after ALI. Interventions targeting potentially modifiable risk factors (e.g., substantial depressive symptoms in early recovery) should be evaluated to improve ALI survivors' long-term outcomes.

Language: en