Life after survival: long-term daily functioning and quality of life after an out-of-hospital cardiac arrest.
BACKGROUND
Information about long-term consequences of cardiac arrest is sparse. Because the survival rate is expected to increase, better knowledge of long-term functioning and quality of survival is essential.


OBJECTIVE
To determine the level of functioning of out-of-hospital cardiac arrest survivors 1-6 years later, and to evaluate the predictive value of medical variables on long-term functioning.


METHODS
A retrospective cohort study including 63 survivors of an out-of-hospital cardiac arrest, admitted to a Dutch University hospital between 2001 and 2006. Participants received a questionnaire by post. Primary outcome measures were: participation in society (Community Integration Questionnaire) and quality of life (SF-36). Secondary outcome measures were: physical, cognitive and emotional impairment, daily functioning and caregiver strain. Statistical analyses included multiple regression analyses.


RESULTS
On average 3 years post-cardiac arrest, 74% of the patients experienced a low participation level in society compared with the general population. Over 50% reported severe fatigue, 38% feelings of anxiety and/or depression and 24% a decreased quality of life. Caregivers reported stress related responses, feelings of anxiety and lower quality of life. Seventeen percent of the caregivers reported high caregiver strain, which was associated with the patient's level of functioning. Gender, age, percutaneous coronary intervention (PCI) and therapeutic hypothermia contributed to outcome on at least one domain of long-term functioning.


CONCLUSIONS
After surviving an out-of-hospital cardiac arrest, many patients and partners encounter extensive impairments in their level of functioning and quality of life. Gender, age, PCI and therapeutic hypothermia are associated with differences in long-term functioning of patients.
Wachelder
E M
EM
Maastricht University, Maastricht, The Netherlands; Rehabilitation Foundation Limburg, Hoensbroek, The Netherlands. E.Wachelder@srl.nl
Moulaert
V R M P
VR
van Heugten
C
C
Verbunt
J A
JA
Bekkers
S C A M
SC
Wade
D T
DT
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects* / Q000379:methods; D017028:Caregivers / Q000523:psychology; D015331:Cohort Studies; D003863:Depression / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006323:Heart Arrest / Q000150:complications / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D012737:Sex Factors; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D016896:Treatment Outcome; D055815:Young Adult