What is the quality of life for survivors of cardiac arrest? A prospective study.
OBJECTIVE
To evaluate the quality of life of survivors of in-hospital and out-of-hospital cardiac arrest, and to correlate quality of life with clinically important parameters.


METHODS
Cohort followed at least six months after hospital discharge. Eligible patients had survived to hospital discharge after sudden cardiac arrest in 1) EDs, wards, and intensive care units of five university hospitals and 2) all locations outside hospitals in two midsized cities. Of 126 patients discharged alive, 30 died before they could be interviewed. Of the 96 patients remaining, 86 (90% of available patients, 68% of survivors to discharge) completed the interview. Quality of life was assessed with the Health Utilities Index Mark 3, which describes health as a utility score on a scale from perfect health (equal to 1.0) to death (equal to 0.)


RESULTS
Mean age (+/- SD) of interviewed survivors was 65 +/- 14 years, and 47 (55%) were male; mean time between collapse and initiation of CPR was 2.2 +/- 2.6 minutes. Mean utility was 0.72 (+/- 0.22). Utilities were significantly higher among patients who had a shorter duration of resuscitation (mean = 0.81 for those who received less than 2 minutes of CPR, 0.76 for those who received 3 to 10 minutes, and 0.65 for others, p = 0.05, r2 = 0.07). Mean utilities of survivors were worse than those of the general population (mean = 0.85 +/- 0.16, p < 0.01) and those whose activities were not limited by chronic disease (mean = 0.91 +/- 0.08, p < 0.01).


CONCLUSIONS
Although overall survival was poor, most survivors had acceptable health-related quality of life. Therefore, concerns about poor quality of life are not a valid reason to abandon efforts to improve the health care system's response to victims of sudden cardiac arrest. Further research is necessary to identify effective strategies for improving both survival and quality of life after cardiac arrest.
Clinical Epidemiology Unit, Loeb Research Institute, University of Ottawa, Ontario, Canada. grahamnichol@earthlink.net
G
G
Nichol
I G
IG
Stiell
P
P
Hebert
G A
GA
Wells
K
K
Vandemheen
A
A
Laupacis
D000368:Aged; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009864:Ontario; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D017741:Survivors