Joblessness is common after ARDS, but related risk factors are not fully understood.What is the association between survivors' pre-ARDS workload and post-ARDS functional impairment, pain, and fatigue with their return to work (RTW) status?The U.S. Occupational Information Network (O*NET) was used to determine pre-ARDS workload for participants in the ARDS Network Long-Term Outcomes Study (ALTOS). Post-ARDS functional impairment was assessed using the Mini-Mental State Examination and SF-36 Physical Functioning, Social Functioning, and Mental Health sub-scales, and categorized as either: no impairments, only psychosocial impairment, physical with low psychosocial impairment, or physical with high psychosocial impairment. Post-ARDS pain and fatigue were assessed using the SF-36 pain item and FACIT-fatigue scale, respectively. Generalized linear mixed modeling methods were used to evaluate associations among pre-ARDS workload, post-ARDS functional impairment, and symptoms of pain and fatigue with post-ARDS RTW.Pre-ARDS workload was not associated with post-ARDS RTW. However, as compared to survivors with no functional impairment, those with only psychosocial impairment (OR [CI]: 0.18 [0.06, 0.50]), as well as physical impairment plus either low psychosocial impairment (0.08 [0.03, 0.22]) or high psychosocial impairment (0.01 [0.003, 0.05]) had lower odds of working. Pain (0.06 [0.03, 0.14]) and fatigue (0.07 [0.03, 0.16]) were also negatively associated with RTW.For previously employed survivors of ARDS, post-ARDS psychosocial and physical impairments, pain, and fatigue were negatively associated with RTW, while pre-ARDS workload was not associated. These findings are important for designing and implementing vocational interventions for ARDS survivors.
Han Su, Hilaire J Thompson, Susanne May, Victor D Dinglas, Catherine L Hough, Megan M Hosey, Ramona O Hopkins, Biren B Kamdar, Dale M Needham