Six Month Quality Of Life And Physical Activity Levels In Survivors Of Pulmonary Critical Illness

PURPOSE: Limited data exists on quality of life (QOL) and physical activity in patients who survive the intensive care unit (ICU) as they transition back into the community. Prior data demonstrate that ICU survivors have low activity in the first week returning home. It remains unknown how activity and QOL changed over the first 6 months. The purpose of this study is to quantify daily steps and QOL in pulmonary ICU survivors across three time points during the first 6 months of recovery. METHODS: We conducted a 6-month prospective observational study of adult survivors of ICU. Patients diagnosed with acute hypoxic respiratory failure or sepsis (≥18 years) were enrolled within 30 days of discharge. Patients completed a QOL survey (EQ-5D, 0 -100) and wore a Garmin Vivo-Fit for a minimum of 10 days to establish mean daily step counts at three time points: discharge, 3 and 6 months. Mean and standard deviations were calculated for step counts and paired t-tests determined significant differences (p = <0.05). Bonferroni corrections were used for multiple comparisons. Bivariate correlations examined the relationship between hospital outcomes, physical activity, and QOL. RESULTS: Forty-three participants had mean age of 55.9 ± 12.9 years and 40% female. Clinical metrics were: hospital stay of 25.4 days (± 20.5 days) and mechanical ventilation of 5.1 ± 7.2 days. Three-month QOL was significantly related to three (r = 0.542, p = 0.045) and 6 month mean steps (r = 0.609, p = 0.047). Six-month quality of life was inversely related to days on mechanical ventilation (r = - 0.824, p = 0.012). Step counts averaged 2,558 ± 2,044 steps at post-discharge, 3,860 ± 2741 at 3 months, and 3,551 ± 2,000 at 6 months after discharge, showing a significant increase from post-discharge to 3 months (p = 0.009) but no significant change from 3 to 6 months (p = 0.559). At 6 months, the mean step counts were below the typical range for healthy adults aged 55 years (4,000-18,000 steps) and fell short of the Centers for Disease Control guidelines of 30 minutes of moderate-intensity physical activity (8,000-11,000 steps) for free-living adults. CONCLUSION: The findings emphasize that survivors of critical illness may require resolute follow up and encouragement up to six months following hospitalization to regain normal aged, related levels of physical activity. Supported by: National Institute of Arthritis and Musculoskeletal and Skin Disorders