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Post-discharge outcomes after resuscitation from out-of-hospital cardiac arrest: A ROC PRIMED substudy.

Abstract：

IMPORTANCE:Assessment of morbidity is an important component of evaluating interventions for patients with out-of-hospital cardiac arrest (OHCA). OBJECTIVE:We evaluated among survivors of OHCA cognition, functional status, health-related quality of life and depression as functions of patient and emergency medical services (EMS) factors. DESIGN:Prospective cohort sub-study of a randomized trial. SETTING:The parent trial studied two comparisons in persons with non-traumatic OHCA treated by EMS personnel participating in the Resuscitation Outcomes Consortium. PARTICIPANTS:Consenting survivors to discharge. MAIN OUTCOME MEASURES:Telephone assessments up to 6 months after discharge included neurologic function (modified Rankin score, MRS), cognitive impairment (Adult Lifestyle and Function Mini Mental Status Examination, ALFI-MMSE), health-related quality of life (Health Utilities Index Mark 3, HUI3) and depression (Telephone Geriatric Depression Scale, T-GDS). RESULTS:Of 15,794 patients enrolled in the parent trial, 729 (56% of survivors) consented. About 644 respondents (88% of consented) completed ≥ 1 assessment. Likelihood of assessment was associated with baseline characteristics and study site. Most respondents had MRS ≤ 3 (82.7%), no cognitive impairment (82.7% ALFI-MMSE ≥ 17), no severe impairment in health (71.6%, HUI3 ≥ 0.7) and no depression (90.1% T-GDS≤10). Outcomes did not differ by trial intervention or time from hospital discharge. CONCLUSIONS AND RELEVANCE:The majority of patients in this large cohort who survived cardiac arrest and were interviewed had no, mild or moderate health impairment. Concern about poor quality of life is not a valid reason to abandon efforts to improve an EMS system's response to cardiac arrest.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Nichol G,Guffey D,Stiell IG,Leroux B,Cheskes S,Idris A,Kudenchuk PJ,Macphee RS,Wittwer L,Rittenberger JC,Rea TD,Sheehan K,Rac VE,Raina K,Gorman K,Aufderheide T,Resuscitation Outcomes Consortium Investigators.

doi

10.1016/j.resuscitation.2015.05.011

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

74-81

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(15)00214-2

journal_volume

93

pub_type

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