期刊
RESUSCITATION
卷 93, 期 -, 页码 74-81出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.resuscitation.2015.05.011
关键词
Cardiac arrest; Prognosis; Quality of life; Depression; Cognition; Functional status
资金
- University of Washington via the Leonard A. Cobb Medic One Foundation Endowed Chair in Prehospital Emergency Care
- National Heart Lung Blood Institute, Bethesda, MD. Resuscitation Outcomes Consortium [NIH U01 HL077863-05]
- Food and Drug Administration, Silver Spring, MD
- Cardiac Science Corp, Waukesha, WI
- Heartsine Technologies Inc., Newtown, PA
- Philips Healthcare Inc., Bothell, WA
- Physio-Control Inc., Redmond, WA
- ZOLL Inc., Chelmsford, MA
- University of Washington Dynamic AED Registry
- Velomedix Inc., Menlo Park, CA
- Toronto site, Resuscitation Outcomes Consortium
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [U01HL077863] Funding Source: NIH RePORTER
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. (C) 2015 Published by Elsevier Ireland Ltd.
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