Measurement of quality of life using EQ-5D in patients on prolonged mechanical ventilation: comparison of patients, family caregivers, and nurses

Hung, Mei-Chuan; Yan, Yuan-Horng; Fan, Po-Sheng; Lin, Ming‐Shyan; Chen, Cheng-Ren; Kuo, Lu-Cheng; Yu, Chi; Yao, Grace; Hsieh, Ching-Lin; Wang, Jung‐Der

doi:10.1007/s11136-010-9629-1

Cited by 26 publications

(28 citation statements)

References 35 publications

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“…According to our previous study, however, most patients undergoing PMV survive only approximately 1.5 to 2 years, and approximately 62% of them suffer from cognitive impairments and poor quality of life. Accounting for these factors results in an overall quality-adjusted life expectancy of only 0.3 to 0.4 and 0.6 to 0.7 quality-adjusted life-years [25,26]. The present study therefore further provided crucial estimates of the median survival and life expectancies of patients undergoing PMV with different diagnoses or co-morbidities, as summarised in Tables 2 and 3.…”

Section: Discussionmentioning

confidence: 87%

Life expectancies and incidence rates of patients under prolonged mechanical ventilation: a population-based study during 1998 to 2007 in Taiwan

Hung

Chen

et al. 2011

Critical Care

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IntroductionThe present study examined the median survival, life expectancies, and cumulative incidence rate (CIR) of patients undergoing prolonged mechanical ventilation (PMV) stratified by different underlying diseases.MethodsAccording to the National Health Insurance Research Database of Taiwan, there were 8,906,406 individuals who obtained respiratory care during the period from 1997 to 2007. A random sample of this population was performed, and subjects who had continuously undergone mechanical ventilation for longer than 21 days were enrolled in the current study. Annual incidence rates and the CIR were calculated. After stratifying the patients according to their specific diagnoses, latent class analysis was performed to categorise PMV patients with multiple co-morbidities into several groups. The life expectancies of different groups were estimated using a semiparametric method with a hazard function based on the vital statistics of Taiwan.ResultsThe analysis of 50,481 PMV patients revealed that incidence rates increased as patients grew older and that the CIR (17 to 85 years old) increased from 0.103 in 1998 to 0.183 in 2004 before stabilising thereafter. The life expectancies of PMV patients suffering from degenerative neurological diseases, stroke, or injuries tended to be longer than those with chronic renal failure or cancer. Patients with chronic obstructive pulmonary disease survived longer than did those co-morbid with other underlying diseases, especially septicaemia/shock.ConclusionsPMV provides a direct means to treat respiratory tract diseases and to sustain respiration in individuals suffering from degenerative neurological diseases, and individuals with either of these types of conditions respond better to PMV than do those with other co-morbidities. Future research is required to determine the cost-effectiveness of this treatment paradigm.

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Section: Discussionmentioning

confidence: 87%

Life expectancies and incidence rates of patients under prolonged mechanical ventilation: a population-based study during 1998 to 2007 in Taiwan

Hung

Chen

et al. 2011

Critical Care

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“…To resolve this difficulty, we conducted a survey of the patient's proxies that included both family caregivers and nurses who directly took care of the patient, which was reported in other studies [27][28][29]34]. The results are summarized in a separate report directly comparing the EQ-5D values of 55 patients with those rated by their family caregivers and nurses [31]. Because EQ-5D contains only two dimensions that require subjective rating, namely, pain/discomfort and anxiety/depression, we found minor differences of the final EQ-5D values between the patient-caregiver pairs and patient-nurse pairs, Ϫ0.03Ϯ0.14, and 0.03Ϯ0.22, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…When the patient's consciousness was too poor to communicate with the interviewer, family caregivers and nurses were used as proxies [27][28][29][30]. We have summarized the detailed methods of validating measurements in another study [31]. Briefly, we invited both family caregivers and nurses who directly took care of the patient to also evaluate the five dimensions of EQ-5D on the patient's behalf based on his/her understanding.…”

Section: Cross-sectional Sample Of Pmv Patients For Utility Measuremementioning

confidence: 99%

Estimation of Quality-Adjusted Life Expectancy in Patients Under Prolonged Mechanical Ventilation

et al. 2011

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“…The sum of the total area under this curve was the QALE with quality-adjusted life years (QALYs) as the common unit [23]. Our QoL data were taken from a sample of 142 patients under PMV and measured using the EQ-5D Health Questionnaire and were classified into either partial or poor cognition [24,25]. Partial cognition was defined as an Mini Mental State Examination score higher than 15.…”

Section: Methodsmentioning

confidence: 99%

Incidence, life expectancy and prognostic factors in cancer patients under prolonged mechanical ventilation: a nationwide analysis of 5,138 cases during 1998-2007

Shih

Hung

et al. 2013

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IntroductionThis study is aimed at determining the incidence, survival rate, life expectancy, quality-adjusted life expectancy (QALE) and prognostic factors in patients with cancer in different organ systems undergoing prolonged mechanical ventilation (PMV).MethodsWe used data from the National Health Insurance Research Database of Taiwan from 1998 to 2007 and linked it with the National Mortality Registry to ascertain mortality. Subjects who received PMV, defined as having undergone mechanical ventilation continuously for longer than 21 days, were enrolled. The incidence of cancer patients requiring PMV was calculated, with the exception of patients with multiple cancers. The life expectancies and QALE of patients with different types of cancer were estimated. Quality-of-life data were taken from a sample of 142 patients who received PMV. A multivariable proportional hazards model was constructed to assess the effect of different prognostic factors, including age, gender, type of cancer, metastasis, comorbidities and hospital levels.ResultsAmong 9,011 cancer patients receiving mechanical ventilation for more than 7 days, 5,138 undergoing PMV had a median survival of 1.37 months (interquartile range [IQR], 0.50 to 4.57) and a 1-yr survival rate of 14.3% (95% confidence interval [CI], 13.3% to 15.3%). The incidence of PMV was 10.4 per 100 ICU admissions. Head and neck cancer patients seemed to survive the longest. The overall life expectancy was 1.21 years, with estimated QALE ranging from 0.17 to 0.37 quality-adjusted life years for patients with poor and partial cognition, respectively. Cancer of liver (hazard ratio [HR], 1.55; 95% CI, 1.34 to 1.78), lung (HR, 1.45; 95% CI, 1.30 to 1.41) and metastasis (HR, 1.53; 95% CI, 1.42 to 1.65) were found to predict shorter survival independently.ConclusionsCancer patients requiring PMV had poor long-term outcomes. Palliative care should be considered early in these patients, especially when metastasis has occurred.

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Measurement of quality of life using EQ-5D in patients on prolonged mechanical ventilation: comparison of patients, family caregivers, and nurses

Abstract: QOL assessments from family caregivers agreed more closely with patients than did those from nurses using EQ-5D evaluations for patients with clear cognition, but either proxy was acceptable for rating PMV patients with poor cognition.

Cited by 26 publications

References 35 publications

Life expectancies and incidence rates of patients under prolonged mechanical ventilation: a population-based study during 1998 to 2007 in Taiwan

Life expectancies and incidence rates of patients under prolonged mechanical ventilation: a population-based study during 1998 to 2007 in Taiwan

Estimation of Quality-Adjusted Life Expectancy in Patients Under Prolonged Mechanical Ventilation

Incidence, life expectancy and prognostic factors in cancer patients under prolonged mechanical ventilation: a nationwide analysis of 5,138 cases during 1998-2007

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