One-year resource utilisation, costs and quality of life in patients with acute respiratory distress syndrome (ARDS): secondary analysis of a randomised controlled trial

Background: The long-term economic and quality-of-life outcomes of patients admitted to intensive care unit (ICU) with acute respiratory distress syndrome are not well understood. In this study, we investigate 1-year costs, survival and quality of life following ICU admission in patients who required mechanical ventilation for acute respiratory distress syndrome. Methods: Economic analysis of data collected alongside a UK-based multi-centre randomised, controlled trial, aimed at comparing high-frequency oscillatory ventilation with conventional mechanical ventilation. The study included 795 critically ill patients admitted to ICU. Hospital costs were assessed using daily data. Post-hospital healthcare costs, patient out-of-pocket expenses, lost earnings of survivors and their carers and health-related quality of life were assessed using follow-up surveys. Results: The mean cost of initial ICU stay was 26,857 pound (95 % CI 25,222- pound 28,491) pound, and the average daily cost in ICU was 1738 pound (CI 1667- pound 1810) pound. Following hospital discharge, the average 1-year cost among survivors was 7523 pound (CI 5692- pound 9354) pound. The mean societal cost at 1 year was 44,077 pound (41,168- pound 46,985) pound, and the total societal cost divided by the number of 1-year survivors was 90,206 pound. Survivors reported significantly lower health-related quality of life than the age-and sex-matched reference population, and this difference was more marked in younger patients. Conclusions: Given the high costs and low health-related quality of life identified, there is significant scope for further research aimed at improving care in this in-need patient group.