Mechanical ventilation, health, and quality of life following spinal cord injury
Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):
2011, vol. 92, issue 3, pp 457-463
Study examined perceived quality of life (QOL) at 1 year postinjury in people with tetraplegia who required mechanical ventilation assistance at discharge from rehabilitation and those who did not. Data were drawn from the SCI Model Systems National Database for 1,635 people with tetraplegia who completed a 1-year follow-up interview, including 79 people who required at least some use of a ventilator at discharge from rehabilitation. Measures used to assess health and QOL included: (1) Satisfaction With Life Scale (SWLS); (2) Craig Handicap Assessment and Reporting Technique (CHART)-Short Form Physical Independence, Mobility, Social Integration, and Occupation subscales; (3) Patient Health Questionnaire-9 (PHQ-9); and (4) Medical Outcomes Study 36-Item Short-Form Health Survey self-perceived health status. Significant differences were found between the ventilator-user (VU) group and non-ventilator users (NVU) for cause of trauma, proportion with complete injury, neurologic impairment level, and number of rehospitalizations. The NVU group had significantly higher SWLS and CHART Social Integration scores than the VU group after controlling for selected covariates. The NVU group also had more positive perceived health status compared with a year previously and a lower incidence of depression assessed by using the PHQ-9 than the VU group. There were no significant differences between groups for perceived current health status. Overall, people who did not require mechanical ventilation at discharge from rehabilitation post-SCI reported generally better health and improved QOL compared with those who required ventilator assistance at 1 year postinjury.
Charlifue S, Apple D, Burns SP, Chen D, Cuthbert JP, Donovan WH, Lammertse DP, Meade MA, Pretz CR
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