Obesity and Smoking Lead to Poorer Quality of Life for ARDS Patients Six Months After Discharge from Hospital, Study Finds

Critical care researchers from Intermountain Medical Center in Salt Lake City studied 616 patients who were treated for ARDS within a large national study to determine what factors played the most significant roles in survivors’ quality of life six months following discharge from the hospital.

Researchers used advanced data science methods to discover the factors that are most related to the quality of recovery after ARDS. They found that patient’s acuity, or level of illness, was not a significant factor in their subsequent quality of life. They found instead that lifestyle factors, specifically obesity and smoking, were associated with a worse quality of life among survivors.

Results of the study were published in the online issue of Thorax, one of the world's leading respiratory medicine journals. 

ARDS is a progressive condition that can occur in patients who are critically ill — such as with a serious pneumonia or significant traumatic injuries.  

The main complication in ARDS is that fluid leaks into the lungs making breathing difficult or impossible without support from a ventilator. A few decades ago, ARDS killed the large majority of patients who acquired it, but recent strides in intensive care have led to improved survival.

With survival rates improving for ARDS patients, understanding and improving their quality of life outcomes is a clinical and research priority, according to the study’s principal investigator Samuel M. Brown, MD, MS, director of the Center for Humanizing Critical Care at Intermountain Medical Center. 

Researchers from the National Institutes of Health ARDS Network, Johns Hopkins University, Brigham Young University and the University of Utah School of Medicine, also participated in the study. 

“The ICU and the critical care environment are so focused on life-and-death issues, and we’re so busy as clinicians, that we often don’t have time to think about lifestyle factors, such as obesity and smoking, and the role they may play in our patients’ long-term quality of life. Our study emphasizes the need for us to consider lifestyle factors more carefully in the critical setting,” Dr. Brown said.

The study’s other important finding is that patients’ level of acuity in the hospital is not a significant predictor of a poor quality of life after they’re discharged from the hospital.

“We see ARDS patients who are very sick and, who at the time, may not look like their quality of life will be good afterward, but our study shows that their level of acuity is not a marker of whether they will experience a high quality of life once they leave the hospital. We found that quality of life for ARDS survivors is more influenced by lifestyle factors.”

Dr. Brown said that study findings suggest that smoking cessation education should be incorporated into the critical care setting. 

“Evidence from our study, in combination with other evidence, suggests there is an urgent need to better support these patients who survive ARDS because they’re confronting new difficulties and unique challenges when they leave the hospital,” said Dr. Brown. 

The next step of this research is to begin to study specific interventions that benefit vulnerable patients at risk for a poor quality of life after hospital discharge, he added.

Other members of the research team included: Emily Wilson, MStat; Angela P. Presson, PhD; Chong Zhang, MS; Victor D. Dinglas, MPH; Tom Green, PhD; Ramona O. Hopkins, PhD; and Dale M. Needham, MD, PhD.