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.
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1 January 2019
Brief Report|
January 01 2019
Hospital Readmission and Subsequent Decline in Long-Term Survivors of Acute Respiratory Distress Syndrome
Amy W. Wozniak, MS;
Amy W. Wozniak, MS
Amy W. Wozniak is a research associate, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and the Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine, Baltimore, Maryland. Elizabeth R. Pfoh is associate staff at the Center for Value-Based Care, Medicine Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Victor D. Dinglas is a research associate, Outcomes After Critical Illness and Surgery Group, and Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine. Peter J. Pronovost is a professor, Outcomes After Critical Illness and Surgery Group, and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine. Dale M. Needham is a professor, Outcomes After Critical Illness and Surgery Group, Division of Pulmonary and Critical Care Medicine, and Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine. Elizabeth Colantuoni is an associate scientist, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine.
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Elizabeth R. Pfoh, PhD, MPH;
Elizabeth R. Pfoh, PhD, MPH
Amy W. Wozniak is a research associate, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and the Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine, Baltimore, Maryland. Elizabeth R. Pfoh is associate staff at the Center for Value-Based Care, Medicine Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Victor D. Dinglas is a research associate, Outcomes After Critical Illness and Surgery Group, and Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine. Peter J. Pronovost is a professor, Outcomes After Critical Illness and Surgery Group, and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine. Dale M. Needham is a professor, Outcomes After Critical Illness and Surgery Group, Division of Pulmonary and Critical Care Medicine, and Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine. Elizabeth Colantuoni is an associate scientist, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine.
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Victor D. Dinglas, MPH;
Victor D. Dinglas, MPH
Amy W. Wozniak is a research associate, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and the Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine, Baltimore, Maryland. Elizabeth R. Pfoh is associate staff at the Center for Value-Based Care, Medicine Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Victor D. Dinglas is a research associate, Outcomes After Critical Illness and Surgery Group, and Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine. Peter J. Pronovost is a professor, Outcomes After Critical Illness and Surgery Group, and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine. Dale M. Needham is a professor, Outcomes After Critical Illness and Surgery Group, Division of Pulmonary and Critical Care Medicine, and Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine. Elizabeth Colantuoni is an associate scientist, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine.
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Peter J. Pronovost, MD, PhD;
Peter J. Pronovost, MD, PhD
Amy W. Wozniak is a research associate, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and the Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine, Baltimore, Maryland. Elizabeth R. Pfoh is associate staff at the Center for Value-Based Care, Medicine Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Victor D. Dinglas is a research associate, Outcomes After Critical Illness and Surgery Group, and Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine. Peter J. Pronovost is a professor, Outcomes After Critical Illness and Surgery Group, and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine. Dale M. Needham is a professor, Outcomes After Critical Illness and Surgery Group, Division of Pulmonary and Critical Care Medicine, and Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine. Elizabeth Colantuoni is an associate scientist, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine.
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Dale M. Needham, MD, PhD;
Amy W. Wozniak is a research associate, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and the Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine, Baltimore, Maryland. Elizabeth R. Pfoh is associate staff at the Center for Value-Based Care, Medicine Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Victor D. Dinglas is a research associate, Outcomes After Critical Illness and Surgery Group, and Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine. Peter J. Pronovost is a professor, Outcomes After Critical Illness and Surgery Group, and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine. Dale M. Needham is a professor, Outcomes After Critical Illness and Surgery Group, Division of Pulmonary and Critical Care Medicine, and Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine. Elizabeth Colantuoni is an associate scientist, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine.
Corresponding author: Dale M. Needham, md, phd, 1830 E Monument St, 5th Floor, Baltimore, Maryland 21287 (email: [email protected]).
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Elizabeth Colantuoni, PhD
Elizabeth Colantuoni, PhD
Amy W. Wozniak is a research associate, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and the Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine, Baltimore, Maryland. Elizabeth R. Pfoh is associate staff at the Center for Value-Based Care, Medicine Institute, Cleveland Clinic Foundation, Cleveland, Ohio. Victor D. Dinglas is a research associate, Outcomes After Critical Illness and Surgery Group, and Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine. Peter J. Pronovost is a professor, Outcomes After Critical Illness and Surgery Group, and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine. Dale M. Needham is a professor, Outcomes After Critical Illness and Surgery Group, Division of Pulmonary and Critical Care Medicine, and Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine. Elizabeth Colantuoni is an associate scientist, Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, and Outcomes After Critical Illness and Surgery Group, Johns Hopkins University School of Medicine.
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Am J Crit Care (2019) 28 (1): 76–80.
Citation
Amy W. Wozniak, Elizabeth R. Pfoh, Victor D. Dinglas, Peter J. Pronovost, Dale M. Needham, Elizabeth Colantuoni; Hospital Readmission and Subsequent Decline in Long-Term Survivors of Acute Respiratory Distress Syndrome. Am J Crit Care 1 January 2019; 28 (1): 76–80. doi: https://doi.org/10.4037/ajcc2019580
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