• Wolfgang Lederer, Christa Lichtenberger, Christoph Pechlaner, Johann Kinzl, Gunnar Kroesen, and Michael Baubin.
• Division of Disaster and Emergency Medicine, Department of Anaesthesia and Critical Care Medicine, The Leopold Franzens University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria. wolfgang.lederer@uibk.ac.at
• Resuscitation. 2004 May 1;61(2):123-9.

ObjectiveThe long-term outcome in patients who received recombinant tissue plasminogen activator during cardiopulmonary resuscitation (CPR) in out-of-hospital cardiac arrest (OHCA) of non-traumatic aetiology was assessed.MethodsThe neurological outcome in survivors and their level of performance, subjective well-being and quality of life were evaluated.ResultsA follow-up study of 27 cardiac arrest survivors was conducted; four patients (15%) died during the first year, a total of seven patients (26%) within 5 years. Twenty-two patients (81%) were discharged from hospital without neurological deficit (cerebral performance category (CPC) score: 1), three patients scored CPC 2 and two patients CPC 3. Heart failure classification on discharge was, according to the New York Heart Association (NYHA) criteria 2.1 +/- 0.9. Fifteen patients (56%) managed to return to their previous level of activity. At the time of follow-up 18 patients (67%) were still alive, of whom 15 responded to a survey regarding life satisfaction. Thirteen patients (87%) judged their situation to be worth living and twelve (80%) considered their survival a second chance, while five (33%) feared they could suffer another cardiac arrest. Reactions from close relatives included fear/anxiety (n = 14; 78%), a sustained burden on family life (n = 12; 67%), and occasional depression (n = 7; 39%).ConclusionsThrombolytic therapy during cardiopulmonary resuscitation may produce a favourable neurological outcome. The majority of long-term survivors reported a good subjective quality of life. In one-third of close family members some negative factors had a lasting impact on the quality of daily living.

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