title: Health-related quality of life is better for cardiac arrest survivors who received citizen cardiopulmonary resuscitation.
abstract: BACKGROUND
  This study evaluated the prehospital factors associated with better health-related quality of life for survivors of out-of-hospital cardiac arrest.
  
  
  RESULTS
  This prospective, 20-community, cohort study involved consecutive, adult out-of-hospital cardiac arrest patients who survived to 1 year. Patients were contacted by telephone and evaluated for the Health Utilities Index Mark III (HUI3), which describes health as a utility score on a scale from 0 (dead) to 1.0 (perfect health). The 8091 cardiac arrest patients had overall survival rates of 5.2% to hospital discharge and 4.0% to 1 year. We successfully contacted and evaluated 268 of 316 (84.8%) of known 1-year survivors. The median HUI3 score was 0.80 (interquartile range, 0.50 to 0.97), which compares well with age-adjusted values for the general population (0.83). Logistic regression identified 2 factors independently associated with very good quality of life (HUI3 >0.90) and their odds ratios (95% CIs), as follows: age 80 years or older, 0.3 (0.1 to 0.84), and citizen-initiated cardiopulmonary resuscitation (CPR), 2.0 (1.2 to 3.4) (Hosmer-Lemeshow goodness-of-fit statistic, 0.74).
  
  
  CONCLUSIONS
  This study is the largest ever conducted for out-of-hospital cardiac arrest survivors, clearly shows that these patients have good quality of life, and is the first to demonstrate that citizen-initiated CPR is strongly and independently associated with better quality of life. These results emphasize the importance of optimizing community citizen CPR readiness. Given the low rate of citizen-initiated CPR in many communities, we believe that local and national initiatives should vigorously promote the practice of bystander CPR.
authors.affiliation: Clinical Epidemiology Unit, Office F657, Ottawa Health Research Institute, 1053 Carling Ave, Ottawa, Ontario K1Y 4E9, Canada. istiell@ohri.ca
authors.forename: Ian
authors.initials: I
authors.lastname: Stiell
authors.forename: Graham
authors.initials: G
authors.lastname: Nichol
authors.forename: George
authors.initials: G
authors.lastname: Wells
authors.forename: Valerie
authors.initials: V
authors.lastname: De Maio
authors.forename: Lisa
authors.initials: L
authors.lastname: Nesbitt
authors.forename: Josée
authors.initials: J
authors.lastname: Blackburn
authors.forename: Daniel
authors.initials: D
authors.lastname: Spaite
mesh_terms: D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000193:education / Q000706:statistics & numerical data*; D015331:Cohort Studies; D004554:Electric Countershock / Q000706:statistics & numerical data*; D004638:Emergency Treatment / Q000706:statistics & numerical data; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009864:Ontario; D011446:Prospective Studies; D011788:Quality of Life; D017741:Survivors / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014838:Volunteers / Q000706:statistics & numerical data