title: Long-term outcomes of out-of-hospital cardiac arrest after successful early defibrillation.
abstract: BACKGROUND
  Mortality after out-of-hospital cardiac arrest from ventricular fibrillation is high. Programs focusing on early defibrillation have improved the rate of survival to hospital discharge. We conducted a population-based analysis of the long-term outcome and quality of life of survivors.
  
  
  METHODS
  All patients who had an out-of-hospital cardiac arrest between November 1990 and January 2001 who received early defibrillation for ventricular fibrillation in Olmsted County, Minnesota, were included. The survival rate was compared with that of an age-, sex-, and disease-matched (2:1) control population of residents who had not had an out-of-hospital cardiac arrest and with that of age- and sex-matched controls from the general U.S. population. The quality of life was assessed with use of the Medical Outcomes Study 36-item Short-Form General Health Survey (SF-36) and compared with U.S. population norms.
  
  
  RESULTS
  Of 200 patients who presented with an out-of-hospital cardiac arrest with ventricular fibrillation, 145 (72 percent) survived to hospital admission (7 died in the emergency department) and 79 (40 percent) were neurologically intact (good overall capability or moderate overall disability) at discharge. The mean (+/-SD) length of follow-up was 4.8+/-3.0 years. Nineteen patients died after discharge from the hospital. The expected five-year survival rate (79 percent) was identical to that among age-, sex-, and disease-matched controls (P=0.68) but lower than that among the age- and sex-matched U.S. population (86 percent, P=0.02). Fifty patients completed SF-36 surveys at the end of follow-up, and the majority had a nearly normal quality of life, with the exception of reduced vitality.
  
  
  CONCLUSIONS
  Long-term survival among patients who have undergone rapid defibrillation after out-of-hospital cardiac arrest is similar to that among age-, sex-, and disease-matched patients who did not have out-of-hospital cardiac arrest. The quality of life among the majority of survivors is similar to that of the general population.
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Rochester, Minn 55905, USA.
authors.forename: T Jared
authors.initials: TJ
authors.lastname: Bunch
authors.forename: Roger D
authors.initials: RD
authors.lastname: White
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Gersh
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Meverden
authors.forename: David O
authors.initials: DO
authors.lastname: Hodge
authors.forename: Karla V
authors.initials: KV
authors.lastname: Ballman
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Hammill
authors.forename: Win-Kuang
authors.initials: WK
authors.lastname: Shen
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Packer
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D017147:Defibrillators, Implantable; D004554:Electric Countershock; D004632:Emergency Medical Services; D005260:Female; D006306:Health Surveys; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006331:Heart Diseases / Q000150:complications / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States; D014693:Ventricular Fibrillation / Q000150:complications