Perceived social support could benefit survivors of acute respiratory failure

Perceived social support may benefit survivors of acute respiratory failure and other critical illnesses, researchers reported in Annals of the American Thoracic Society.

“Nationally representative cohort studies have shown that being able to identify a friend or relative who could help with personal care is protective against prolonged nursing home stays for adults [older than] 65, and social isolation before an ICU admission is associated with increased disability burden and mortality in the year following critical illness,” Alison E. Turnbull, DVM, MPH, PhD, associate professor of medicine at Johns Hopkins University School of Medicine and Bloomberg School of Public Health, and colleagues wrote. “Despite being widely recognized as a risk factor for poor health outcomes, there is little quantitative research on social isolation and perceived social support following critical illness.”

Turnbull and colleagues reported data on perceived social support as part of the APICS-01 prospective cohort study. The researchers reported data from 200 survivors of acute respiratory failure who were discharged to home from six hospitals at five U.S. academic medical centers from January 2019 to August 2020. Researchers defined acute respiratory failure as at least 24 consecutive hours of mechanical ventilation via endotracheal tube, noninvasive ventilation or high-flow nasal cannula and measured perceived social support using the 12-item Multidimensional Scale of Perceived Social Support (MSPSS), with higher scores indicating greater support.

By 6 months, 65% of survivors (median age, 53 years; 54% women) completed the MSPSS, 23% did not complete the MSPSS, 9% died and 5% were lost to follow-up.

Researchers reported a decrease in the median total score compared with discharge among the 77% of survivors who completed the 3-month MSPSS (70 vs. 72; P = .001) and among the 65% of survivors who completed the 6-month MSPSS (72 vs. 73; P = .005).

Following weighted adjustments, the median MSPSS score for all survivors at 6 months was substantially lower compared with hospital discharge (56 vs. 73; P < .001). Further, the median score at discharge was higher among survivors who completed the 6-month MSPSS compared with those who did not complete the assessment (73 vs. 69; P = .002).

“The trajectory of perceived social support we observed is consistent with systematic reviews of stroke survivors for whom perceived social support remains relatively stable, even as measures of social isolation, such as social network size, number of friends and the frequency of involvement in social activities, general decrease,” Turnbull and colleagues wrote.

The researchers said an important avenue for future research is to study related concepts like social isolation, loneliness and family functioning after acute respiratory failure.

“While it is premature to make clinical recommendations, our findings suggest a mechanism by which professionally moderated support groups could provide benefit following critical illness. ... Given the robust association between social support and life satisfaction in other populations, exploring the potential role of social connection is an important new frontier for [acute respiratory failure] survivorship research,” Turnbull and colleagues wrote.