Long-term survival and neurological outcome of patients who received recombinant tissue plasminogen activator during out-of-hospital cardiac arrest.
OBJECTIVE
The 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.


METHODS
The neurological outcome in survivors and their level of performance, subjective well-being and quality of life were evaluated.


RESULTS
A 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%).


CONCLUSIONS
Thrombolytic 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.
Lederer
Wolfgang
W
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
Lichtenberger
Christa
C
Pechlaner
Christoph
C
Kinzl
Johann
J
Kroesen
Gunnar
G
Baubin
Michael
M
D000328:Adult; D000368:Aged; D001317:Austria; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D004632:Emergency Medical Services; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000453:epidemiology* / Q000209:etiology; D011336:Probability; D016016:Proportional Hazards Models; D011788:Quality of Life; D012189:Retrospective Studies; D016019:Survival Analysis; D017741:Survivors; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
D010959:Tissue Plasminogen Activator