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Tracheostomy in patients with acute respiratory distress syndrome is not related to quality of life, symptoms of psychiatric disorders or return-to-work: the prospective DACAPO cohort study

2020; Springer Nature; Volume: 10; Issue: 1 Linguagem: Inglês

10.1186/s13613-020-00671-x

2110-5820

Sebastian Blecha, Magdalena Brandl, Florian Zeman, Frank Dodoo‐Schittko, Susanne Brandstetter, Christian Karagiannidis, Thomas Bein, Christian Apfelbacher, Johannes Bickenbach, Thorben Beeker, Tobias Schürholz, Jessica Pezechk, Jens Schloer, Ulrich Jaschinski, Ilse Kummer, Oliver Kuckein, Steffen Weber‐Carstens, Anton Goldmann, Stefan Angermair, Krista Stoycheva, Jörg Brederlau, Nadja Rieckehr, Gabriele Schreiber, Henriette Haennicke, Friedhelm Bach, Immo Gummelt, Silke Haas, Catharina Middeke, Ina Vedder, Marion Klaproth, Michael Adamzik, Jan Karlik, Stefan Martini, Luisa Robitzky, Christian Putensen, Thomas Muders, Ute Lohmer, Rolf Dembinski, Petra Schäffner, Petra Wulff-Werner, Elke Landsiedel-Mechenbier, Daniela Nickoleit-Bitzenberger, Ann-Kathrin Silber, Maximilian Ragaller, Marcello Gama de Abreu, Alin Ulbricht, Linda Reisbach, Kai Zacharowski, Patrick Meybohm, Alexander Hötzel, Johannes Kalbhenn, Christoph Metz, Stefan Haschka, Stefan Rauch, Michael Quintel, Lars-Olav Harnisch, Sophie Baumann, Andrea Kernchen, Sigrun Friesecke, Sebastian Maletzki, Stefan Kluge, Olaf Boenisch, Daniel Frings, Birgit Füllekrug, Nils Jahn, Knut Kampe, Grit Ringeis, Brigitte Singer, Robin Wüstenberg, Jörg Ahrens, H. Ruschulte, Andre Gerdes, Matthias Groß, Olaf Wiesner, Aleksandra Bayat-Graw, Thorsten Brenner, Felix C. F. Schmitt, A Lipiński, Dietrich Henzler, Klaas Eickmeyer, Juliane Krebs, Iris Rodenberg, Heinrich V. Groesdonk, Kathrin Meiers, Karen Salm, Thomas Volk, Stefan Fischer, Basam Redwan, Martin Schmölz, Kathrin Schumann-Stoiber, Simone Eberl, Gunther Lenz, Thomas von Wernitz-Keibel, Monika Zackel, Frank Bloos, Petra Bloos, Anke Braune, Anja Haucke, Almut Noack, Steffi Kolanos, Heike Kuhnsch, Karina Knuhr-Kohlberg, Markus Gehling, Mathias Haller, Anne Sturm, Jannik Rossenbach, Dirk Schädler, Stefanie D’Aria, Christian Karagiannidis, Stephan Straßmann, Wolfram Windisch, Thorsten Annecke, Holger Herff, Michael Schütz, Sven Bercker, Hannah Reising, Mandy Dathe, Christian Schlegel, Katrin Lichy, Wolfgang Zink, Jana Kötteritzsch, Marc Bodenstein, Susanne Mauff, Péter Straub, Christof Strang, Florian Prätsch, Thomas Hachenberg, Thomas Kirschning, Thomas Friedrich, Dennis Mangold, Christian Arndt, T. Koch, Hendrik Haake, Katrin Offermanns, Patrick Friederich, Florian Bingold, Michael Irlbeck, Bernhard Zwißler, Inès Kaufmann, Ralph Bogdanski, Barbara Kapfer, Markus Heim, Günther Edenharter, Björn Ellger, Daniela Bause, G. Gerresheim, Dorothea Muschner, Michael Christ, Arnim Geise, Martin Beiderlinden, Thorsten Heuter, Alexander Wipfel, Werner Kargl, Marion Harth, Christian Englmeier, Thomas Bein, Sebastian Blecha, Kathrin Thomann-Hackner, Marius Zeder, Markus Stephan, Martin Gläser, Helene Häberle, Hendrik Bracht, Christian Heer, Theresa Mast, Markus Kredel, Ralf Müllenbach, Phillip Sebök, Kathrin Thomann-Hackner, Julika Loss, Bernhard Gräf, Michael F. Leitzmann, Michael Pfeifer, Simon Bein, Vreni Brunnthaler, Carina Forster, Stefanie Hertling, Sophie Höhne, Carolin Schimmele, Elisa Valletta,

Intensive Care Unit Cognitive Disorders

Acute respiratory distress syndrome (ARDS) is a life-threatening condition that often requires prolonged mechanical ventilation. Tracheostomy is a common procedure with some risks, on the other hand with potential advantages over orotracheal intubation in critically ill patients. This study investigated the association of tracheostomy with health-related quality of life (HRQoL), symptoms of psychiatric disorders and return-to-work of ARDS survivors.Data were collected in the context of the prospective observational German-wide DACAPO study. Clinical and demographic patient data and treatment characteristics were obtained from the participating intensive care units (ICU). HRQoL and return-to-work were assessed using patient-reported questionnaires 3, 6 and 12 months after ICU discharge. HRQoL was measured with the Physical and Mental Component Scale of the Short-Form 12 Questionnaire (PCS-12, MCS-12). The prevalence of psychiatric symptoms (depression and post-traumatic stress disorder [PTSD]) was assessed using the Patient Health Questionnaire-9 and the Post-Traumatic Stress Syndrome-14. Physician-diagnosed anxiety and obsessive-compulsive disorder were recorded by patient self-report in the follow-up questionnaires. The associations of tracheostomy with HRQoL, psychiatric symptoms and return-to-work after 12 months were investigated by means of multivariable linear and logistic regression models.Primary 877 ARDS patients (mean ± standard deviation: 54 ± 16 years, 68% male) survived and were discharged from ICU. Out of these patients, 478 (54.5%) were tracheotomised during ICU treatment. After 12 months, patient-reported outcomes could be analysed of 388 (44.2%) respondents, 205 with tracheostomy and 183 without. One year after ICU discharge, tracheostomy showed no significant association with physical or mental health-related quality of life (PCS-12: - 0.73 [- 3.96, 2.51]; MCS-12: - 0.71 [- 4.92, 3.49]), symptoms of psychiatric disorders (depression: 0.10 [- 1.43, 1.64]; PTSD: 3.31 [- 1.81, 8.43]; anxiety: 1.26 [0.41, 3.86]; obsessive-compulsive disorder: 0.59 [0.05, 6.68]) or return-to-work (0.71 [0.31, 1.64]) in the multivariable analysis (OR [95%-CI]).Up to 1 year after ICU discharge, neither HRQoL nor symptoms of psychiatric disorders nor return-to-work was affected by tracheostomy. Trial registration NCT02637011 (ClinicalTrials.gov, Registered 15 December 2015, retrospectively registered).