Post-discharge outcomes after resuscitation from out-of-hospital cardiac arrest: A ROC PRIMED substudy

the Resuscitation Outcomes Consortium Investigators

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)74-81
Number of pages8
JournalResuscitation
Volume93
DOIs
StatePublished - Aug 1 2015

Fingerprint

Out-of-Hospital Cardiac Arrest
Resuscitation
Depression
Emergency Medical Services
Telephone
Survivors
Quality of Life
Health
Heart Arrest
Geriatrics
Life Style
Cognition
Nervous System
Cohort Studies
Outcome Assessment (Health Care)
Morbidity

Keywords

  • Cardiac arrest
  • Cognition
  • Depression
  • Functional status
  • Prognosis
  • Quality of life

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

Cite this

Post-discharge outcomes after resuscitation from out-of-hospital cardiac arrest : A ROC PRIMED substudy. / the Resuscitation Outcomes Consortium Investigators.

In: Resuscitation, Vol. 93, 01.08.2015, p. 74-81.

Research output: Contribution to journalArticle

the Resuscitation Outcomes Consortium Investigators. / Post-discharge outcomes after resuscitation from out-of-hospital cardiac arrest : A ROC PRIMED substudy. In: Resuscitation. 2015 ; Vol. 93. pp. 74-81.
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abstract = "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.",
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author = "{the Resuscitation Outcomes Consortium Investigators} and Graham Nichol and Danielle Guffey and Stiell, {Ian G.} and Brian Leroux and Sheldon Cheskes and Ahamed Idris and Kudenchuk, {Peter J.} and Macphee, {Renee S.} and Lynn Wittwer and Rittenberger, {Jon C.} and Rea, {Thomas D.} and Kellie Sheehan and Rac, {Val E.} and Keitki Raina and Kyle Gorman and Tom Aufderheide",
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T2 - A ROC PRIMED substudy

AU - the Resuscitation Outcomes Consortium Investigators

AU - Nichol, Graham

AU - Guffey, Danielle

AU - Stiell, Ian G.

AU - Leroux, Brian

AU - Cheskes, Sheldon

AU - Idris, Ahamed

AU - Kudenchuk, Peter J.

AU - Macphee, Renee S.

AU - Wittwer, Lynn

AU - Rittenberger, Jon C.

AU - Rea, Thomas D.

AU - Sheehan, Kellie

AU - Rac, Val E.

AU - Raina, Keitki

AU - Gorman, Kyle

AU - Aufderheide, Tom

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N2 - 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.

AB - 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.

KW - Cardiac arrest

KW - Cognition

KW - Depression

KW - Functional status

KW - Prognosis

KW - Quality of life

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