Changes in Quality of Life and Health Status in Patients with Extracorporeal Life Support: A Prospective Longitudinal Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2018 May 11

PMID 29746522

Citations 7

Authors

Kang-Hua Chen

Yu-Ting Chen

Shu-Ling Yeh

Li-Chueh Weng

Feng-Chun Tsai

Affiliations

Soon will be listed here.

Abstract

Background: Extracorporeal life support (ECLS) provides emergency pulmonary and cardiac assistance for patients in respiratory or cardiac failure. Most studies evaluate the success of ECLS based on patients' survival rate. However, the trajectory of health status and quality of life (QOL) should also be important considerations. The study's aim was to explore changes in health status and QOL in adult patients weaned from ECLS who survived to hospital discharge over a one-year period.

Study Design: A prospective longitudinal study was conducted from April 2012 to September 2014. A convenience sample of patients who had undergone ECLS was followed for one-year after hospital discharge. Heath status was measured with a physical activity scale, the Centre for Epidemiologic Studies Depression scale, and a social support scale; we assessed quality of life with the physical and mental component summary scales of the Short-Form 36 Health Survey. Changes in depression, social support, physical activity and QOL were analysed with generalized estimating equations at 3-month intervals; participants' QOL at 12 months after discharge was compared with the general population.

Results: A total of 231 patients received ECLS during the study period. Sixty-five patients survived to hospital discharge (28% survival rate); 32 participants completed the study. Data showed scores for physical activity increased significantly over time (p < .001), while depression and social support significantly decreased (p < .05 and p < .001, respectively). Participants with veno-venous ECLS had higher scores for depression than participants with veno-arterial ECLS (p < .05). PCS scores significantly increased at 9, and 12 months after discharge (p < .05 and p < .001, respectively). There was no significant change in MCS scores.

Conclusions: This was a preliminary study of patients with ECLS following hospital discharge over a one-year period. One year following hospital discharge survivors of ECLS continued to experience physical complications and some continued to have depressive symptoms; the level of social support was significantly lower after hospital discharge. Healthcare professionals should understand the trajectory of health status and QOL after discharge, which can help developing evidence-based interventions and improve QOL for survivors of ECLS.

Citing Articles

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Long-Term Survival and Quality of Life in Non-Surgical Adult Patients Supported with Veno-Arterial Extracorporeal Oxygenation.

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Post-Discharge Depression Status for Survivors of Extracorporeal Membrane Oxygenation (ECMO): Comparison of Veno-Venous ECMO and Veno-Arterial ECMO.

Lin W, Chang Y, Weng L, Tsai F, Huang H, Yeh S Int J Environ Res Public Health. 2022; 19(6).

PMID: 35329031 PMC: 8954682. DOI: 10.3390/ijerph19063333.

References

Lewinsohn P, Seeley J, Roberts R, Allen N . Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults. Psychol Aging. 1997; 12(2):277-87. DOI: 10.1037//0882-7974.12.2.277. View

Brechot N, Luyt C, Schmidt M, Leprince P, Trouillet J, Leger P . Venoarterial extracorporeal membrane oxygenation support for refractory cardiovascular dysfunction during severe bacterial septic shock. Crit Care Med. 2013; 41(7):1616-26. DOI: 10.1097/CCM.0b013e31828a2370. View

Tseng M, Liang J, Shyu Y, Wu C, Cheng H, Chen C . Effects of interventions on trajectories of health-related quality of life among older patients with hip fracture: a prospective randomized controlled trial. BMC Musculoskelet Disord. 2016; 17:114. PMC: 4776406. DOI: 10.1186/s12891-016-0958-2. View

Jette A, Davies A, Cleary P, Calkins D, Rubenstein L, Fink A . The Functional Status Questionnaire: reliability and validity when used in primary care. J Gen Intern Med. 1986; 1(3):143-9. DOI: 10.1007/BF02602324. View

Hodgson C, Hayes K, Everard T, Nichol A, Davies A, Bailey M . Long-term quality of life in patients with acute respiratory distress syndrome requiring extracorporeal membrane oxygenation for refractory hypoxaemia. Crit Care. 2012; 16(5):R202. PMC: 3682304. DOI: 10.1186/cc11811. View

Schmidt M, Zogheib E, Roze H, Repesse X, Lebreton G, Luyt C . The PRESERVE mortality risk score and analysis of long-term outcomes after extracorporeal membrane oxygenation for severe acute respiratory distress syndrome. Intensive Care Med. 2013; 39(10):1704-13. PMC: 7094902. DOI: 10.1007/s00134-013-3037-2. View

Wu M, Lee M, Lin C, Chang Y, Tsai F, Lin P . Resuscitation of non-postcardiotomy cardiogenic shock or cardiac arrest with extracorporeal life support: the role of bridging to intervention. Resuscitation. 2012; 83(8):976-81. DOI: 10.1016/j.resuscitation.2012.01.010. View

Nordgren L, Soderlund A . Received and needed social support in relation to sociodemographic and socio-economic factors in a population of people on sick leave due to heart failure. ESC Heart Fail. 2017; 4(1):46-55. PMC: 5292631. DOI: 10.1002/ehf2.12121. View

Anselmi P, Vidotto G, Bettinardi O, Bertolotti G . Measurement of change in health status with Rasch models. Health Qual Life Outcomes. 2015; 13:16. PMC: 4341816. DOI: 10.1186/s12955-014-0197-x. View

10.

Lemmens K, Nieboer A, Huijsman R . Designing patient-related interventions in COPD care: empirical test of a theoretical model. Patient Educ Couns. 2008; 72(2):223-31. DOI: 10.1016/j.pec.2008.04.003. View

11.

Wu M, Lin P, Lee M, Tsai F, Chu J, Chang Y . Using extracorporeal life support to resuscitate adult postcardiotomy cardiogenic shock: treatment strategies and predictors of short-term and midterm survival. Resuscitation. 2010; 81(9):1111-6. DOI: 10.1016/j.resuscitation.2010.04.031. View

12.

Hsieh F, Huang G, Ko W, Lou M . Health status and quality of life of survivors of extra corporeal membrane oxygenation: a cross-sectional study. J Adv Nurs. 2016; 72(7):1626-37. DOI: 10.1111/jan.12943. View

13.

Ma Y, Mazumdar M, Memtsoudis S . Beyond repeated-measures analysis of variance: advanced statistical methods for the analysis of longitudinal data in anesthesia research. Reg Anesth Pain Med. 2011; 37(1):99-105. PMC: 3249227. DOI: 10.1097/AAP.0b013e31823ebc74. View

14.

Hsu P, Chen J, Hong G, Tsai Y, Lin C, Lee C . Extracorporeal membrane oxygenation for refractory cardiogenic shock after cardiac surgery: predictors of early mortality and outcome from 51 adult patients. Eur J Cardiothorac Surg. 2009; 37(2):328-33. DOI: 10.1016/j.ejcts.2009.07.033. View

15.

McHorney C, Ware Jr J, Raczek A . The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care. 1993; 31(3):247-63. DOI: 10.1097/00005650-199303000-00006. View

16.

Pieri M, Greco T, De Bonis M, Maj G, Fumagalli L, Zangrillo A . Diagnosis of infection in patients undergoing extracorporeal membrane oxygenation: a case-control study. J Thorac Cardiovasc Surg. 2012; 143(6):1411-6. DOI: 10.1016/j.jtcvs.2012.01.005. View

17.

Luyt C, Combes A, Becquemin M, Beigelman-Aubry C, Hatem S, Brun A . Long-term outcomes of pandemic 2009 influenza A(H1N1)-associated severe ARDS. Chest. 2012; 142(3):583-592. DOI: 10.1378/chest.11-2196. View

18.

Guttendorf J, Boujoukos A, Ren D, Rosenzweig M, Hravnak M . Discharge outcome in adults treated with extracorporeal membrane oxygenation. Am J Crit Care. 2014; 23(5):365-77. DOI: 10.4037/ajcc2014115. View

19.

Mirabel M, Luyt C, Leprince P, Trouillet J, Leger P, Pavie A . Outcomes, long-term quality of life, and psychologic assessment of fulminant myocarditis patients rescued by mechanical circulatory support. Crit Care Med. 2011; 39(5):1029-35. DOI: 10.1097/CCM.0b013e31820ead45. View

20.

Muller G, Flecher E, Lebreton G, Luyt C, Trouillet J, Brechot N . The ENCOURAGE mortality risk score and analysis of long-term outcomes after VA-ECMO for acute myocardial infarction with cardiogenic shock. Intensive Care Med. 2016; 42(3):370-378. DOI: 10.1007/s00134-016-4223-9. View