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. 2019 Jun 14;9(1):70.
doi: 10.1186/s13613-019-0544-5.

Ambulatory and stationary healthcare use in survivors of ARDS during the first year after discharge from ICU: findings from the DACAPO cohort

Susanne Brandstetter  1 , Frank Dodoo-Schittko  2 , Magdalena Brandl  2 , Sebastian Blecha  3 , Thomas Bein  3 , Christian Apfelbacher  2   4 ; DACAPO study group
Collaborators, Affiliations

Ambulatory and stationary healthcare use in survivors of ARDS during the first year after discharge from ICU: findings from the DACAPO cohort

Susanne Brandstetter et al. Ann Intensive Care. .

Abstract

Background: For many survivors of acute respiratory distress syndrome (ARDS), the process from discharge from intensive care unit (ICU) to recovery is long and difficult. However, healthcare use after discharge from ICU has received only little attention by research. This study sets out to investigate the extent of ambulatory and stationary healthcare use among survivors of ARDS in Germany (multicenter DACAPO cohort) and to analyze predictors of stationary healthcare use.

Results: A total of 396 survivors of ARDS provided data at 1 year after discharge from ICU. Fifty percent of 1-year survivors were hospitalized for 48 days or longer after discharge from ICU, with 10% spending more than six out of 12 months in stationary care. The duration of hospitalization increased significantly by the length of the initial ICU stay. All participants reported at least one outpatient visit (including visits to general practitioners), and 50% contacted four or more different medical specialties within the first year after discharge from ICU.

Conclusions: For most of the patients, the first year after ARDS is characterized by an extensive amount of healthcare utilization, especially with regard to stationary health care. These findings shed light on the substantial morbidity of patients after ARDS and contribute to a better understanding of the situation of patients following discharge from ICU.

Keywords: ARDS; Ambulatory health care; Critical illness; Health services research; Healthcare use; Post-ICU; Stationary health care.

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Conflict of interest statement

TB received honoraria for lectures from Xenios Company, Germany. All other authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Patient flow. Notes: ICU intensive care unit. aFor all patients who were lost to follow-up, survival was assessed via local municipal population registries. bWritten informed consent and patient data were transferred to the study centre with a delay of more than 12 months; thus, follow-up measurement was not possible within the scheduled follow-up period
Fig. 2
Fig. 2
Number of inpatient stays (a) and days of hospitalization (b) during the first year after discharge from ICU. Notes: N = 387 for inpatient stays, N = 359 for days of hospitalization; inpatient stays included stays in hospitals (ICU or normal ward) and rehabilitation units; subsequent stays were considered distinct from each other if there was a change in the hospital or if a stay within a hospital was interrupted by at least one night at home. Referrals within one institution (e.g., from normal ward to ICU and vv.) were considered a single stay
See this image and copyright information in PMC

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