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Long-term Outcome After Survival of a Cardiac Arrest: A Prospective Longitudinal Cohort Study
Véronique R M Moulaert1,2, Caroline M van Heugten3, Ton P M Gorgels2
11 Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, Netherlands.
Insights
Cardiac arrest survivors show reassuring long-term recovery in daily activities and quality of life. However, fatigue, cognitive issues, and emotional problems are common, impacting return to work.
Area of Science:
- Neurology
- Cardiology
- Rehabilitation Medicine
Background:
- Cardiac arrest can cause hypoxic brain injury, affecting overall functioning.
- Understanding long-term outcomes post-cardiac arrest is crucial for patient care.
Purpose of the Study:
- To investigate the 1-year outcome and recovery patterns in cardiac arrest survivors.
- To assess physical, cognitive, emotional, and quality of life aspects post-cardiac arrest.
Main Methods:
- Multicenter, prospective longitudinal cohort study with 1-year follow-up.
- Assessed physical function, cognition (Cognitive Log), emotions (HADS, IES), fatigue (FSS), activities (FAI), participation (CIQ), and quality of life (EQ-5D, SF-36).
Main Results:
- 141 survivors were followed; 13% had cognitive deficits at 1 year.
- 52% reported severe fatigue, 15% anxiety/depression, 28% PTSD symptoms.
- Activities (FAI) and participation (CIQ) recovered to 96% and 92% of pre-arrest levels; 72% returned to work.
Conclusions:
- Long-term outcomes for activities, participation, and quality of life are generally positive.
- Fatigue, cognitive, and emotional challenges persist in many survivors.
- Return to work is a potential area of concern for cardiac arrest survivors.
Background:
A cardiac arrest can lead to hypoxic brain injury, which can affect all levels of functioning.
Objective:
To investigate 1-year outcome and the pattern of recovery after surviving a cardiac arrest.
Methods:
This was a multicenter, prospective longitudinal cohort study with 1 year of follow-up (measurements 2 weeks, 3 months, 1 year). On function level, physical/cardiac function (New York Heart Association Classification), cognition (Cognitive Log [Cog-log], Cognitive Failures Questionnaire), emotional functioning (Hospital Anxiety and Depression Scale, Impact of Event Scale), and fatigue (Fatigue Severity Scale) were assessed. In addition, level of activities (Frenchay Activities Index, FAI), participation (Community Integration Questionnaire [CIQ] and return to work), and quality of life (EuroQol 5D, EuroQol Visual Analogue Scale, SF-36, Quality of Life after Brain Injury) were measured.
Results:
In this cohort, 141 cardiac arrest survivors were included. At 1 year, 14 (13%) survivors scored below cutoff on the Cog-log. Both anxiety and depression were present in 16 (15%) survivors, 29 (28%) experienced posttraumatic stress symptoms and 55 (52%), severe fatigue. Scores on the FAI and the CIQ were, on average, respectively 96% and 92% of the prearrest scores. Of those previously working, 41 (72%) had returned to work. Most recovery of cognitive function and quality of life occurred within the first 3 months, with further improvement on some domains of quality of life up to 12 months.
Conclusions:
Overall, long-term outcome in terms of activities, participation, and quality of life after cardiac arrest is reassuring. Nevertheless, fatigue is common; problems with cognition and emotions occur; and return to work can be at risk.
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