Health-related quality of life as predictor for mortality in patients treated with long-term mechanical ventilation

Markussen, Heidi Øksnes; Lehmann, Sverre; Nilsen, Roy Miodini; Natvig, Gerd Karin

doi:10.1186/s12890-018-0768-4

Cited by 13 publications

(11 citation statements)

References 57 publications

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“…Five-year mortality was considerable, being highest among COPD and NMD patients, mostly progressive diseases, and lowest in the RCWD group, reflecting the non-progressive nature of this group. In line with previous studies, the time-to-death on HMV varies widely across disease groups with CRF and is lower in progressive diseases [ 13 , 35 ].…”

Section: Discussionsupporting

confidence: 89%

“…A recent comparison showed that both SRI and MRF-26 were reliable in patients receiving HMV, but that the SRI was superior in assessing psychological health impairments [ 12 ]. In addition, a cohort study found that SRI score was associated with mortality of patients with long-term HMV and proposed the use of SRI in the daily clinic as part of patients’ follow-up [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Long-term health-related quality of life in patients on home mechanical ventilation

et al. 2022

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Background It is fundamental to optimize and retain health-related quality of life (HRQoL) in the long term in patients with home mechanical ventilation (HMV). Therefore, this study aimed to evaluate the evolution of the HRQoL in patients already established on HMV across a period of 5 years and whether the HRQoL is associated with mortality. Methods This was a 5-year longitudinal cohort study conducted in an Outpatient Ventilation Clinic. Consecutive patients on HMV for at least 30 days responded to the Severe Respiratory Insufficiency (SRI) questionnaire at inclusion and again at 5 years. Results A total of 104 patients were included (male 56.7%, median age 69 [P25;P75] [61;77] years). Almost half of the patients had COPD (49.0%). Patients were on HMV for a median of 43.5 [22;85.5] months, with overall good adherence (median 8 [6;9] daily hours). Fifty-seven (54.8%) patients were alive at 5 years. In surviving patients, the only difference with statistical significance was in the attendant symptoms and sleep subscale, with patients scoring 7.1 [-4.5;25] points higher in the final questionnaire (p = 0.002). Survivors had significantly better scores in the SRI at inclusion than deceased patients (median 59.6 [49.2;71.7] vs 48.7 [38.4;63.2]; p = 0.004). Conclusions These results shows that HRQoL remains stable in surviving patients with HMV at five years. It also suggests that SRI can be of important prognostic value and help predict the terminal phase of the disease course in patients with long-term HMV.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Long-term health-related quality of life in patients on home mechanical ventilation

et al. 2022

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“…Research into the health-related quality of life among patients receiving PMV has commonly focused on patients treated with noninvasive ventilation, with assessment based on either single-item questions or tools such as the EQ-5D (EuroQol-5 Dimensions) 35 or more recently the Severe Respiratory Insufficiency questionnaire. 36 This 49-item test has typically been used among patients with advanced lung disease, as well as those treated with noninvasive ventilation, 37 and evaluates the impact of respiratory insufficiency on several aspects of health-related quality of life including respiratory complaints, physical function, attendant symptoms, social relationships, anxiety, psychological well-being, and social functioning. Findings have varied considerably depending on the patient population, with more severe symptoms described among older patients with chronic lung disease as compared to younger patient population with progressive neuromuscular disease.…”

Section: Discussionmentioning

confidence: 99%

Prolonged Mechanical Ventilation: Symptomatology, Well-Being, and Attitudes to Life

Jacobs

Marcus

Stessman

2021

Journal of the American Medical Directors Association

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Objective Although prolonged mechanical ventilation (PMV) is increasingly common, little is known concerning patient symptom burden or attitudes toward PMV. This study aims to describe the mood, well-being, distressing symptoms, and attitudes toward prolonged ventilation among PMV patients treated either at home or long-term acute care (LTAC). Design An observational study. Setting and Participants 62 communicative participants treated with PMV, aged ≥18 years, insurees of a single HMO, treated at home hospital or LTAC specializing in ventilation in Jerusalem. Measures Sociodemographic characteristics; chronic conditions; functional status; symptom burden measured by revised Edmonton Symptomatic Assessment System (r-ESAS); attitudes toward PVM. Results Participants were aged 61.7 ± 20.7 years, commonly suffered progressive neuromuscular disease (43.5%) or chronic lung disease (29%), were functionally dependent, treated at home (64.5%) or LTAC (35.5%), and had a mean PMV duration of 36.6 months (interquartile range 10.8-114.1). The 5-item, short Geriatric Depression Scale identified depression among 38% of participants, and was less at home vs LTAC (34% vs 44%, P < .001). Mean revised Edmonton Symptom Assessment System score was 24.5 ± 14.8 (maximum severity = 100), and participants reported severe or distressing symptoms for tiredness (27%/20%), pain (10%/25%), anxiety (16%/14%), depression (9%/21%), drowsiness (12%/17%), shortness of breath (9%/15%), poor appetite (7%/9%), and nausea (0%/10%). Impaired general well-being was reported as severe, moderate, mild, or none among 15%, 40%, 30%, and 15%, respectively. Only 1 patient had advance directives concerning ventilation prior to intubation, and when asked if they had to choose again today, 85% of patients would again opt for ventilation. Conclusions and Implications Few PMV patients reported distressing symptoms, and 85% would choose ventilation if asked again. These findings might be useful in clinical practice to assist in decision making concerning prolonged ventilation.

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“…The precise analysis of patients’ illness stages and the treatment role in all interventions’ assessments are urgent needs that warrant quality, evidence-based data, which is unavailable currently. COPD patients with distinct therapies have experiences characteristic of their treatment group [6,7,61]. Thus, it is difficult to understand the methodological approach in some studies where, despite a small sample size, the patients’ treatments, or even COPD stages, are neither provided nor included in analyses [57,62].…”

Section: Discussionmentioning

confidence: 99%

Psychosocial Interventions for Patients with Severe COPD—An Up-to-Date Literature Review

Rzadkiewicz

Nasiłowski

2019

Medicina

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Background and Objectives: Chronic obstructive pulmonary disease (COPD) is a life limiting condition with a long list of serious psychosocial consequences, aggravating with illness progression. In advanced stages, chronic respiratory failure often develops, which might undermine mental health and reduce activity. The study objective was to review the recent studies concerning psychosocial interventions dedicated to patients with severe COPD. Materials and Methods: The PubMed database was searched for terms, such as ‘COPD and long-term oxygen therapy, non-invasive ventilation, severe or respiratory failure’ and ‘psychological or psychosocial or mental health and intervention.’ Studies were included that described patients with stable, severe COPD and the outcomes of psychosocial interventions. Results and Conclusions: Thirty-four studies were identified and divided into four thematic groups: home medical support, exercise, self-management and mental health. The number of studies that focused on mental health preservation in severe COPD was very limited; i.e., none refer directly to those treated with respiratory failure. Improving patients’ self-efficacy gave promising effects to the acceptance of palliative care, pulmonary rehabilitation completion and mental health. Physical activity might be recommended to be included in interventions for mental health enhancement, although little is known about the role of the particular forms of exercise. An increasing beneficial use of new technologies for psychosocial interventions was noted. Psychosocial interventions applied in advanced COPD underline the roles of self-efficacy, telehealth and physical activity in physical and mental health preservation. However, all of the above elements need to be independently tested on more homogenous groups of patients and have the possible modes of their treatment analysed.

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Health-related quality of life as predictor for mortality in patients treated with long-term mechanical ventilation

Cited by 13 publications

References 57 publications

Long-term health-related quality of life in patients on home mechanical ventilation

Long-term health-related quality of life in patients on home mechanical ventilation

Prolonged Mechanical Ventilation: Symptomatology, Well-Being, and Attitudes to Life

Psychosocial Interventions for Patients with Severe COPD—An Up-to-Date Literature Review

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