Hospital Readmission and Subsequent Decline in Long-Term Survivors of Acute Respiratory Distress Syndrome

Acute respiratory distress syndrome is associated with long-term physical impairments. Although readmission is common, little is known about the impact of readmissions on the physical status of this population. The purpose of this study was to evaluate the association between hospital readmission, with or without an intensive care unit stay, and physical status in survivors of acute respiratory distress syndrome. The exposure was hospital readmission, categorized as (1) no readmission, (2) readmitted 1 or more times without an intensive care unit stay, or (3) readmitted 1 or more times with an intensive care unit stay. The incidence of readmission was assessed during years 3, 4, and 5 of the study. The outcome was physical decline or death. Decline was evaluated via 3 separate measures: muscle strength, exercise capacity, and self-reported physical function. Of the 132 survivors, 64% (n = 84) had 1 or more readmissions and 27% (n = 35) of them had 1 or more intensive care unit stays. Rates of decline in the year prior were similar regardless of readmission status in the current year. Multivariable logistic regression models indicated that readmission without an intensive care unit stay versus no readmission was not significantly associated with decline. Readmission with an intensive care unit stay versus no readmission was associated with physical decline. Clinicians and researchers should consider the effect of a readmission to an intensive care unit, distinct from hospital readmission, on acute respiratory distress syndrome survivors’ physical status.