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Resuscitation ; 93: 74-81, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26025570

RESUMO

IMPORTANCE: 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. DESIGN: Prospective cohort sub-study of a randomized trial. SETTING: The parent trial studied two comparisons in persons with non-traumatic OHCA treated by EMS personnel participating in the Resuscitation Outcomes Consortium. PARTICIPANTS: Consenting survivors to discharge. MAIN OUTCOME MEASURES: 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 AND RELEVANCE: 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.


Assuntos
Reanimação Cardiopulmonar , Cognição , Depressão , Nível de Saúde , Parada Cardíaca Extra-Hospitalar/terapia , Qualidade de Vida , Sobreviventes , Canadá , Reanimação Cardiopulmonar/efeitos adversos , Reanimação Cardiopulmonar/métodos , Depressão/diagnóstico , Depressão/etiologia , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Seguimentos , Humanos , Entrevistas como Assunto , Masculino , Avaliação de Resultados em Cuidados de Saúde , Alta do Paciente/estatística & dados numéricos , Testes Psicológicos , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos , Estados Unidos
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