One-year resource utilisation, costs and quality of life in patients with acute respiratory distress syndrome (ARDS): secondary analysis of a randomised controlled trial

Joachim Marti, Peter Hall, Patrick Hamilton, Sarah Lamb, Chris McCabe, Ranjit Lall, Julie Darbyshire, Duncan Young, Claire Hulme, Joachim Marti, Peter Hall, Patrick Hamilton, Sarah Lamb, Chris McCabe, Ranjit Lall, Julie Darbyshire, Duncan Young, Claire Hulme

Abstract

Background: The long-term economic and quality-of-life outcomes of patients admitted to intensive care unit (ICU) with acute respiratory distress syndrome are not well understood. In this study, we investigate 1-year costs, survival and quality of life following ICU admission in patients who required mechanical ventilation for acute respiratory distress syndrome.

Methods: Economic analysis of data collected alongside a UK-based multi-centre randomised, controlled trial, aimed at comparing high-frequency oscillatory ventilation with conventional mechanical ventilation. The study included 795 critically ill patients admitted to ICU. Hospital costs were assessed using daily data. Post-hospital healthcare costs, patient out-of-pocket expenses, lost earnings of survivors and their carers and health-related quality of life were assessed using follow-up surveys.

Results: The mean cost of initial ICU stay was £26,857 (95 % CI £25,222-£28,491), and the average daily cost in ICU was £1738 (CI £1667-£1810). Following hospital discharge, the average 1-year cost among survivors was £7523 (CI £5692-£9354). The mean societal cost at 1 year was £44,077 (£41,168-£46,985), and the total societal cost divided by the number of 1-year survivors was £90,206. Survivors reported significantly lower health-related quality of life than the age- and sex-matched reference population, and this difference was more marked in younger patients.

Conclusions: Given the high costs and low health-related quality of life identified, there is significant scope for further research aimed at improving care in this in-need patient group.

Trial registration: ISRCTN10416500.

Figures

Fig. 1
Fig. 1
Flow chart of study population
Fig. 2
Fig. 2
Kaplan-Meier survival plots at 12 months

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