Abstract
BackgroundExtracorporeal life support (ECLS) provides emergency pulmonary and cardiac assistance for patients in respiratory or cardiac failure. Most studies evaluate the success of ECLS based on patients’ survival rate. However, the trajectory of health status and quality of life (QOL) should also be important considerations. The study’s aim was to explore changes in health status and QOL in adult patients weaned from ECLS who survived to hospital discharge over a one-year period.Study designA prospective longitudinal study was conducted from April 2012 to September 2014. A convenience sample of patients who had undergone ECLS was followed for one-year after hospital discharge. Heath status was measured with a physical activity scale, the Centre for Epidemiologic Studies Depression scale, and a social support scale; we assessed quality of life with the physical and mental component summary scales of the Short-Form 36 Health Survey. Changes in depression, social support, physical activity and QOL were analysed with generalized estimating equations at 3-month intervals; participants’ QOL at 12 months after discharge was compared with the general population.ResultsA total of 231 patients received ECLS during the study period. Sixty-five patients survived to hospital discharge (28% survival rate); 32 participants completed the study. Data showed scores for physical activity increased significantly over time (p < .001), while depression and social support significantly decreased (p < .05 and p < .001, respectively). Participants with veno-venous ECLS had higher scores for depression than participants with veno-arterial ECLS (p < .05). PCS scores significantly increased at 9, and 12 months after discharge (p < .05 and p < .001, respectively). There was no significant change in MCS scores.ConclusionsThis was a preliminary study of patients with ECLS following hospital discharge over a one-year period. One year following hospital discharge survivors of ECLS continued to experience physical complications and some continued to have depressive symptoms; the level of social support was significantly lower after hospital discharge. Healthcare professionals should understand the trajectory of health status and QOL after discharge, which can help developing evidence-based interventions and improve QOL for survivors of ECLS.
Highlights
Cardiac or respiratory disease patients in critical condition need comprehensive medical care
The study’s aim was to explore changes in health status and quality of life (QOL) in adult patients weaned from Extracorporeal life support (ECLS) who survived to hospital discharge over a one-year period
This was a preliminary study of patients with ECLS following hospital discharge over a oneyear period
Summary
Cardiac or respiratory disease patients in critical condition need comprehensive medical care. Extracorporeal life support (ECLS) is a cardiopulmonary bypass procedure, which can provide additional time for diagnosis and treatment of cardiac disease [1] and rescue therapy for acute respiratory or cardiac failure and extracorporeal cardiopulmonary resuscitation (ECPR) [2,3]. In order to understand the impact of ECLS on patient outcomes, studies have focused on predictors of in-hospital mortality and weaning from ECLS [6,14,15], survival rate [6,7,8], complication rate [13,16,17], physical and psychological health status [13,16,17], and quality of life (QOL) [13,16,17].there have been no longitudinal studies on QOL for patients with ECLS after discharge. The study’s aim was to explore changes in health status and QOL in adult patients weaned from ECLS who survived to hospital discharge over a one-year period
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