German-wide prospective DACAPO cohort of survivors of the acute respiratory distress syndrome (ARDS): a cohort profile

Frank Dodoo-Schittko, Susanne Brandstetter, Magdalena Brandl, Sebastian Blecha, Michael Quintel, Steffen Weber-Carstens, Stefan Kluge, Thomas Kirschning, Thomas Muders, Sven Bercker, Björn Ellger, Christian Arndt, Patrick Meybohm, Michael Adamzik, Anton Goldmann, Christian Karagiannidis, Thomas Bein, Christian Apfelbacher, DACAPO Study Group, Frank Dodoo-Schittko, Susanne Brandstetter, Magdalena Brandl, Sebastian Blecha, Michael Quintel, Steffen Weber-Carstens, Stefan Kluge, Thomas Kirschning, Thomas Muders, Sven Bercker, Björn Ellger, Christian Arndt, Patrick Meybohm, Michael Adamzik, Anton Goldmann, Christian Karagiannidis, Thomas Bein, Christian Apfelbacher, DACAPO Study Group

Abstract

Purpose: While most research focuses on the association between medical characteristics and residual morbidity of survivors of the acute respiratory distress syndrome (ARDS), little is known about the relation between potentially modifiable intensive care unit (ICU) features and the course of health-related quality of life (HRQoL). Accordingly, the DACAPO study was set up to elucidate the influence of quality of intensive care on HRQoL and return to work (RtW) in survivors of ARDS. The continued follow-up of these former ICU patients leads to the establishment of the DACAPO (survivor) cohort.

Participants: Sixty-one ICUs all over Germany recruited patients with ARDS between September 2014 and April 2016. Inclusion criteria were: (1) age older than 18 years and (2) ARDS diagnosis according to the 'Berlin definition'. No further inclusion or exclusion criteria were applied. 1225 patients with ARDS could be included in the DACAPO ICU sample. Subsequently, the 876 survivors at ICU discharge form the actual DACAPO cohort.

Findings to date: The recruitment of the participants of the DACAPO cohort and the baseline data collection has been completed. The care-related data of the DACAPO cohort reveal a high proportion of adverse events (in particular, hypoglycaemia and reintubation). However, evidence-based supportive measures were applied frequently.

Future plans: Three months, 6 months and 1 year after ICU admission a follow-up assessment is conducted. The instruments of the follow-up questionnaires comprise the domains: (A) HRQoL, (B) RtW, (C) general disability, (D) psychiatric symptoms and (E) social support. Additionally, an annual follow-up of the DACAPO cohort focusing on HRQoL, psychiatric symptoms and healthcare utilisation will be conducted. Furthermore, several add-on projects affecting medical issues are envisaged.

Trial registration number: NCT02637011.

Keywords: acute respiratory distress syndrome (ards); epidemiology; health-related quality of life; icu; return to work.

Conflict of interest statement

Competing interests: None declared.

© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Figures

Figure 1
Figure 1
Patient flow of the DACAPO cohort. ICU, intensive care unit.
Figure 2
Figure 2
Main objectives and add-on projects using data of the DACAPO ICU sample/DACAPO cohort. (I) Main objective of the DACAPO study; (II) main objective of the DACAPO cohort; (III) genetic add-on project; and (IV) add-on projects with clinical background. aAn additional DNA analysis for the participants of the DACAPO cohort is intended. bFor some of the research questions, a retrospective collection of medical data is required. cAn additional follow-up with specific measurement instruments is intended for some research questions. ARDS, acute respiratory distress syndrome; HRQoL, health-related quality of life; HCU, healthcare utilisation; ICU, intensive care unit; PTSD, post-traumatic stress disorder; QoC, quality of care; RtW, return to work.

References

    1. Pierrakos C, Karanikolas M, Scolletta S, et al. . Acute respiratory distress syndrome: pathophysiology and therapeutic options. J Clin Med Res 2012;4:7–16. 10.4021/jocmr761w
    1. Ranieri VM, Rubenfeld GD, Thompson BT, et al. . Acute respiratory distress syndrome: the Berlin Definition. JAMA 2012;307:2526–33. 10.1001/jama.2012.5669
    1. Bellani G, Laffey JG, Pham T, et al. . Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 Countries. JAMA 2016;315:788–800. 10.1001/jama.2016.0291
    1. Scholten EL, Beitler JR, Prisk GK, et al. . Treatment of acute respiratory distress syndrome with prone positioning. Chest 2016.
    1. Sen A, Callisen HE, Alwardt CM, et al. . Adult venovenous extracorporeal membrane oxygenation for severe respiratory failure: Current status and future perspectives. Ann Card Anaesth 2016;19:97–111. 10.4103/0971-9784.173027
    1. Dowdy DW, Eid MP, Dennison CR, et al. . Quality of life after acute respiratory distress syndrome: a meta-analysis. Intensive Care Med 2006;32:1115–24. 10.1007/s00134-006-0217-3
    1. McHorney CA, Ware JE, Raczek AE. 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;31:247–63.
    1. Herridge MS, Tansey CM, Matté A, et al. . Functional disability 5 years after acute respiratory distress syndrome. N Engl J Med 2011;364:1293–304. 10.1056/NEJMoa1011802
    1. Bienvenu OJ, Colantuoni E, Mendez-Tellez PA, et al. . Cooccurrence of and remission from general anxiety, depression, and posttraumatic stress disorder symptoms after acute lung injury: a 2-year longitudinal study. Crit Care Med 2015;43:642–53. 10.1097/CCM.0000000000000752
    1. Davydow DS, Desai SV, Needham DM, et al. . Psychiatric morbidity in survivors of the acute respiratory distress syndrome: a systematic review. Psychosom Med 2008;70:512–9. 10.1097/PSY.0b013e31816aa0dd
    1. Dodoo-Schittko F, Brandstetter S, Blecha S, et al. . Determinants of quality of life and return to work following acute respiratory distress syndrome. Dtsch Arztebl Int 2017;114:103–9. 10.3238/arztebl.2017.0103
    1. Dodoo-Schittko F, Brandstetter S, Brandl M, et al. . Characteristics and provision of care of patients with the acute respiratory distress syndrome: descriptive findings from the DACAPO cohort baseline and comparison with international findings. J Thorac Dis 2017;9:818–30. 10.21037/jtd.2017.03.120
    1. Brandstetter S, Dodoo-Schittko F, Blecha S, et al. . Influence of quality of care and individual patient characteristics on quality of life and return to work in survivors of the acute respiratory distress syndrome: protocol for a prospective, observational, multi-centre patient cohort study (DACAPO). BMC Health Serv Res 2015;15:563 10.1186/s12913-015-1232-2
    1. Braun JP, Kumpf O, Deja M, et al. . The German quality indicators in intensive care medicine 2013--second edition. Ger Med Sci 2013;11 10.3205/000177
    1. Le Gall JR, Lemeshow S, Saulnier F. A new simplified acute physiology score (saps ii) based on a european/north american multicenter study. JAMA 1993;270:2957–63. 10.1001/jama.1993.03510240069035
    1. Moreno RP, Metnitz PG, Almeida E, et al. . SAPS 3--From evaluation of the patient to evaluation of the intensive care unit. Part 2: Development of a prognostic model for hospital mortality at ICU admission. Intensive Care Med 2005;31:1345–55. 10.1007/s00134-005-2763-5
    1. Vincent JL, Moreno R, Takala J, et al. . The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. On behalf of the Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine. Intensive Care Med 1996;22:707–10.
    1. Ware J, Kosinski M, Keller SD. A 12-Item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care 1996;34:220–33.
    1. Fydrich T, Sommer G, Brähler E. Social support questionnaire (F-SozU) manual. Göttingen, Germany: Hogrefe, 2007.
    1. Löwe B, Spitzer RL, Zipfel S, et al. . PHQ-D Health questionnaire for patients. Manual]. Pfizer GmbH, Karlsruhe 2002.
    1. Gräfe KZS, Herzog W, Löwe B. Screening for psychiatric disorders with the Patient Health Questionnaire (PHQ). Results from the German validation study]. Diagnostica 2004;50:11.
    1. Spitzer RL, Williams JB, Kroenke K, et al. . Validity and utility of the PRIME-MD patient health questionnaire in assessment of 3000 obstetric-gynecologic patients: the PRIME-MD Patient Health Questionnaire Obstetrics-Gynecology Study. Am J Obstet Gynecol 2000;183:759–69. 10.1067/mob.2000.106580
    1. Radtke FM, Franck M, Drews T, et al. . The post-traumatic stress syndrome 14-Questions Inventory (PTSS-14) - Translation of the UK-PTSS-14 and validation of the German version. Anasthesiol Intensivmed Notfallmed Schmerzther 2010;45:688–95. 10.1055/s-0030-1268870
    1. Miyakawa M, Magnusson Hanson LL, Theorell T, et al. . Subjective social status: its determinants and association with health in the Swedish working population (the SLOSH study). Eur J Public Health 2012;22:593–7. 10.1093/eurpub/ckr064
    1. Park SY, Kim HJ, Yoo KH, et al. . The efficacy and safety of prone positioning in adults patients with acute respiratory distress syndrome: a meta-analysis of randomized controlled trials. J Thorac Dis 2015;7:356–67. 10.3978/j.issn.2072-1439.2014.12.49
    1. Guérin C, Reignier J, Richard JC, et al. . Prone positioning in severe acute respiratory distress syndrome. N Engl J Med 2013;368:2159–68. 10.1056/NEJMoa1214103
    1. Papazian L, Forel JM, Gacouin A, et al. . Neuromuscular blockers in early acute respiratory distress syndrome. N Engl J Med 2010;363:1107–16. 10.1056/NEJMoa1005372

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