title: Post-discharge outcomes after resuscitation from out-of-hospital cardiac arrest: A ROC PRIMED substudy.
abstract: OBJECTIVE
  Assessment of morbidity is an important component of evaluating interventions for patients with out-of-hospital cardiac arrest (OHCA).
  
  
  OBJECTIVE
  We evaluated among survivors of OHCA cognition, functional status, health-related quality of life and depression as functions of patient and emergency medical services (EMS) factors.
  
  
  METHODS
  Prospective cohort sub-study of a randomized trial.
  
  
  METHODS
  The parent trial studied two comparisons in persons with non-traumatic OHCA treated by EMS personnel participating in the Resuscitation Outcomes Consortium.
  
  
  METHODS
  Consenting survivors to discharge.
  
  
  METHODS
  Telephone assessments up to 6 months after discharge included neurologic function (modified Rankin score, MRS), cognitive impairment (Adult Lifestyle and Function Mini Mental Status Examination, ALFI-MMSE), health-related quality of life (Health Utilities Index Mark 3, HUI3) and depression (Telephone Geriatric Depression Scale, T-GDS).
  
  
  RESULTS
  Of 15,794 patients enrolled in the parent trial, 729 (56% of survivors) consented. About 644 respondents (88% of consented) completed ≥ 1 assessment. Likelihood of assessment was associated with baseline characteristics and study site. Most respondents had MRS ≤ 3 (82.7%), no cognitive impairment (82.7% ALFI-MMSE ≥ 17), no severe impairment in health (71.6%, HUI3 ≥ 0.7) and no depression (90.1% T-GDS≤10). Outcomes did not differ by trial intervention or time from hospital discharge.
  
  
  CONCLUSIONS
  The majority of patients in this large cohort who survived cardiac arrest and were interviewed had no, mild or moderate health impairment. Concern about poor quality of life is not a valid reason to abandon efforts to improve an EMS system's response to cardiac arrest.
authors.affiliation: Clinical Trial Center, Department of Biostatistics, University of Washington, Seattle, WA, United States; University of Washington-Harborview Center for Prehospital Emergency Care, Department of Medicine, University of Washington, Seattle, WA, United States. Electronic address: nichol@uw.edu.
authors.forename: Graham
authors.initials: G
authors.lastname: Nichol
authors.affiliation: Clinical Trial Center, Department of Biostatistics, University of Washington, Seattle, WA, United States.
authors.forename: Danielle
authors.initials: D
authors.lastname: Guffey
authors.affiliation: Department of Emergency Medicine, University of Ottawa, Ottawa Health Research Institute, Ottawa, ON, Canada.
authors.forename: Ian G
authors.initials: IG
authors.lastname: Stiell
authors.affiliation: Clinical Trial Center, Department of Biostatistics, University of Washington, Seattle, WA, United States.
authors.forename: Brian
authors.initials: B
authors.lastname: Leroux
authors.affiliation: Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital and Sunnybrook Center for Prehospital Medicine, Division of Emergency Medicine, Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Sheldon
authors.initials: S
authors.lastname: Cheskes
authors.affiliation: Departments of Emergency Medicine and Internal Medicine, University of Texas Southwestern, Dallas, TX, United States.
authors.forename: Ahamed
authors.initials: A
authors.lastname: Idris
authors.affiliation: King County EMS, Seattle and King County Public Health, and Department of Medicine, University of Washington, Seattle, WA, United States.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Kudenchuk
authors.affiliation: Wilfrid Laurier University, Waterloo, ON, Canada.
authors.forename: Renee S
authors.initials: RS
authors.lastname: Macphee
authors.affiliation: Clark County Emergency Medical Services, Vancouver, WA, United States.
authors.forename: Lynn
authors.initials: L
authors.lastname: Wittwer
authors.affiliation: Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
authors.forename: Jon C
authors.initials: JC
authors.lastname: Rittenberger
authors.affiliation: King County EMS, Seattle and King County Public Health, and Department of Medicine, University of Washington, Seattle, WA, United States.
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Rea
authors.affiliation: Clinical Trial Center, Department of Biostatistics, University of Washington, Seattle, WA, United States.
authors.forename: Kellie
authors.initials: K
authors.lastname: Sheehan
authors.affiliation: Toronto Health Economics and Technology Assessment Collaborative, Institute of Health Policy, Measurement and Evaluation, University of Toronto, Toronto, ON, Canada.
authors.forename: Val E
authors.initials: VE
authors.lastname: Rac
authors.affiliation: Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
authors.forename: Keitki
authors.initials: K
authors.lastname: Raina
authors.affiliation: Clackamas Fire District #1, Clackamas, OR, United States.
authors.forename: Kyle
authors.initials: K
authors.lastname: Gorman
authors.affiliation: Medical College of Wisconsin, Milwaukee, WI, United States.
authors.forename: Tom
authors.initials: T
authors.lastname: Aufderheide
mesh_terms: D002170:Canada; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000379:methods; D003071:Cognition; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge / Q000706:statistics & numerical data; D011581:Psychological Tests; D011788:Quality of Life; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data; D014481:United States
keywords: Cardiac arrest; Cognition; Depression; Functional status; Prognosis; Quality of life