Background
Fatigue is commonly reported by ARDS survivors, but empirical data are scarce.
Research Question
This study evaluated fatigue prevalence and associated variables in a prospective
study of ARDS survivors.
Study Design and Methods
This analysis is part of the ARDSNet Long-Term Outcomes Study (ALTOS) conducted at
38 US hospitals. Using age- and sex-adjusted, time-averaged random effects regression
models, we evaluated associations between the validated Functional Assessment of Chronic
Illness Therapy-Fatigue Scale with patient and critical illness variables, and with
physical, cognitive, and mental health status at 6 and 12 months following ARDS.
Results
Among ARDS survivors, 501 of 711 (70%) and 436 of 659 (66%) reported clinically significant
symptoms of fatigue at 6 and 12 months, respectively, with 41% and 28% reporting clinically
important improvement and worsening (n = 638). At 6 months, the prevalence of fatigue
(70%) was greater than that of impaired physical functioning (50%), anxiety (42%),
and depression (36%); 46% reported both impaired physical function and fatigue, and
27% reported co-existing anxiety, depression, and fatigue. Fatigue was less severe
in men and in those employed prior to ARDS. Critical illness variables (eg, illness
severity, length of stay) had little association with fatigue symptoms. Worse physical,
cognitive, and mental health symptoms were associated with greater fatigue at both
the 6- and 12-month follow-up.
Interpretation
During the first year following ARDS, more than two-thirds of survivors reported clinically
significant fatigue symptoms. Due to frequent co-occurrence, clinicians should evaluate
and manage survivors’ physical, cognitive, and mental health status when fatigue is
endorsed.
Key Words
Abbreviations:
APACHE III ( Acute Physiology and Chronic Health Evaluation III), FACIT-F ( Functional Assessment of Chronic Illness Therapy-Fatigue Scale), SF-36v2 ( Short Form-36 Version 2)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: April 15, 2020
Footnotes
FUNDING/SUPPORT: This research was supported by the National Heart, Lung, and Blood Institute [Grants R24 HL111895 , R01HL091760 , and R01HL091760-02S1 ], the Johns Hopkins Institute for Clinical and Translational Research [Grant UL1 TR 000424-06 ], and the Albuterol for Treatment of Acute Lung Injury Trial (ALTA), Early Versus Delayed Enteral Nutrition Trial (EDEN), Omega Nutrition Supplement Trial (OMEGA), and Statins for Acutely Injured Lungs from Sepsis Trial (SAILS) [ National Heart, Lung, and Blood Institute contracts HHSN268200536165C to HHSN268200536176C and HHSN268200536179C ].
Identification
Copyright
© 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
