Abstract
BackgroundSocial support (SS) may contribute to the long-term recovery of critical illness survivors. This study focuses on survivors of the acute respiratory distress syndrome (ARDS) to investigate the causal relationship between SS and health related quality of life (HRQoL) and healthcare utilization in critically ill patients.MethodsA cohort study with N=877 ARDS survivors in 61 ICUs was conducted in Germany, between 2014 and 2019. SS (F-SozU K-14) and HRQoL (Physical and Mental Component Scale: PCS, MCS of the SF-12) were assessed at 3, 6, 12, and 24 months after ICU discharge. Healthcare utilization was assessed after 12 and 24 months. To identify confounders and allow for causal inferences, a directed acyclic graph (DAG) was developed.ResultsAdjusted regression models demonstrated significant positive impact of SS on mental HRQoL after three months onward (all ßs >0.15, allps <0.05). This influence increases over time. In contrast, the influence of SS on physical HRQoL and healthcare utilization remained inconclusive (only one significant association for physical HRQoL at 12 months: β=0.128, p<0.05, otherwise allps >0.05).ConclusionResults indicate SS plays an important and unique role in the long-term recovery of survivors of critical illness in the mental area. It appears that the more distal mechanism of SS unfolds progressively over time, perhaps as the immediate sequelae of critical illness after discharge subside. In contrast, SS does not appear to exert a substantial causal impact on physical HRQoL and healthcare utilization.
Published Version
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