RT Journal Article
SR Electronic
T1 Physical activity levels, primary care costs and quality-adjusted life years (QALYs) in survivors of critical illness
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3688
VO 44
IS Suppl 58
A1 Angela McNelly
A1 Ritesh Maharaj
A1 Jai Rawal
A1 Pearl Chan
A1 Nicholas Hopkinson
A1 John Moxham
A1 Steven Harridge
A1 Nicholas Hart
A1 Hugh Montgomery
A1 Zudin Puthucheary
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P3688.abstract
AB Background: Limitation to daily physical activity (PA) is common in Intensive Care Unit (ICU) survivors. We assessed PA, primary care costs (PCC) and Quality-Adjusted Life Years (QALYs) in ICU survivors.Methods:Subjects were drawn from the Musculoskeletal Ultrasound Study in Critical Care: Longitudinal Evaluation Study (Clinical Trials.gov Identifier: NCT01106300), all invasively ventilated for >48 hours and on ICU >7days. We assessed PA (accelerometry [Sensewear Pro, BodyMedia Inc, Pittsburgh, USA] and SF-36 survey [QualityMetric, Lincoln, USA]), QALYs (SF-6D conversion) and PCC (2009-2010; Personal Social Services Research Unit report) 18 months post-ICU discharge.Results: 27 patients were studied (14 female; mean±SEM age 56.6±3.6 years; post-ICU discharge 576±190 days). Median Physical Function domain scores (SF-36) and accelerometry-derived daily steps were highly correlated (r=0.69;p<0.01), and lower than those from normal controls. Cumulative PCC in the 18-months post-ICU discharge were 5-fold higher for ICU survivors than for normal controls (mean±SEM: £1210±274,£238±11;p=0.0025) and QALYs lower (mean±SEM: 0.92±0.045, 1.16±0.01;p=2.48x10-6). Multiple regression indicated that Physical and Mental Component Summary scores (SF-36) contributed significantly to QALYs (r2=0.64,0.62;p=0.0005; β=0.55,0.51;p=0.001), and daily steps weakly (r2=0.07;NS). PCC showed a weak inverse association with QALYs (r2=0.14;NS).Conclusions: Both subjective and objective measures suggest that PA and QALYs are reduced at 18 months in ICU survivors; healthcare costs are higher. Impaired PA may contribute to reduced QALYs.