• Resuscitation · Apr 2022

    Very long-term survivors of in-hospital and out-of-hospital cardiac arrest show considerable impairment of daily life.

    • Sebastian Schnaubelt, Florian B Mayr, Heidrun Losert, Hans Domanovits, Patrick Sulzgruber, Michael Holzer, Fritz Sterz, and Thomas Uray.
    • Department of Emergency Medicine, Medical University of Vienna, Austria. Electronic address: sebastian.schnaubelt@meduniwien.ac.at.
    • Resuscitation. 2022 Apr 1; 173: 192-200.

    BackgroundReliable data on long-term outcomes after cardiac arrest (CA) remain scarce. Identifying factors persistently impacting the quality of life after CA is crucial to improve long-term outcomes.MethodsAdult in- and out-of-hospital CA patients surviving to hospital discharge between 1996 and 2015 were retrospectively included. We classified survivors in stages of survival time and assessed long-term survival and quality of life by contacting patients via a standardized telephone questionnaire including the modified Rankin Scale (mRS).ResultsOf 4,234 patients, 1,573 (37.2%) survived to hospital discharge. Among those, 693(44.1%) were alive at the time of the interview. We obtained interviews in 178 patients at a survival time of 7.8 (4.2-12.6) years. Younger age, female gender, and shorter duration of initial hospitalization and coma were associated with long-term survival. Conversely, higher median age at time of CA predicted poor outcome (mRS ≥ 3) and impaired quality of daily life. Around 25% declared being impaired in mobility, with female gender and higher age being predictors. Impairment in personal care and hygiene was stated in 11.8%, and activities of daily life such as shopping troubled 33.1%. Chronic pain impairing daily life was reported in 47.2% of cases, and lower socioeconomic status was suggestive of unfavourable outcome.ConclusionVery long-term survivors showed considerable impairment of quality of life in terms of reduced mobility, self-care, or chronic pain. Higher age at time of CA and lower socioeconomic status showed worse outcomes. A more personalized screening of survivors for risk factors and long-term support are suggested.Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.

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