Long-Term Functional Outcome and Quality of Life Following In-Hospital Cardiac Arrest—A Longitudinal Cohort Study

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Gemma M. Pound ◽  
Daryl Jones ◽  
Glenn M. Eastwood ◽  
Eldho Paul ◽  
Carol L. Hodgson
Resuscitation ◽  
2017 ◽  
Vol 113 ◽  
pp. 77-82 ◽  
Author(s):  
Guillaume Geri ◽  
Florence Dumas ◽  
Franck Bonnetain ◽  
Wulfran Bougouin ◽  
Benoit Champigneulle ◽  
...  

2021 ◽  
Vol 10 (19) ◽  
pp. 4451
Author(s):  
Aleksander Och ◽  
Piotr Tylicki ◽  
Karolina Polewska ◽  
Ewelina Puchalska-Reglińska ◽  
Aleksandra Parczewska ◽  
...  

Background: After recovery from COVID-19, patients frequently face so-called “Post-COVID-19 Syndrome” defined by clusters of persistent symptoms lasting for >12 weeks which may arise from any system in the body. The long-term health consequences of COVID-19 in maintenance hemodialyzed (HD) patients remain to be investigated. Methods: In this longitudinal cohort study we described the health consequences in HD patients requiring hospitalization due to COVID-19. They were interviewed three and six months (M3 and M6) after discharge with a series of standardized questionnaires. Results: Of 144 HD patients discharged from the 7th Naval Hospital in Gdansk, 79 participants were enrolled, 39 m (49.4%) and 40 f (50.6%) with a median age of 70.0 (64.0–76.5) and an HD vintage of 40 months (17.5–88). After discharge, 93.7% and 81% reported at least one persistent symptom at M3 and M6, respectively. The most common symptoms were fatigue or muscle weakness (60.76% and 47.04%) and palpitations (40.51% and 30.14%). Dyspnea with an mMRC scale grade of at least 1 was reported by 21.5% before infection, and by 43.03% and 34.25% at M3 and M6, respectively. A decrease in the quality of life was reported in all domains of the EQ-5D-5L questionnaire but mainly in the pain/discomfort and anxiety dimensions. Mean EQ-VAS scores were 69.05, 61.58 and 64.38, respectively. Conclusion: Our study showed that HD patients may still experience persistent symptoms six months after recovery from COVID-19, which can further reduce their already poor health-related quality of life. This study highlights the need for long-term follow-up on these patients for diagnostic and rehabilitation programs.


CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S53
Author(s):  
E. Mercier ◽  
E. Andrew ◽  
Z. Nehme ◽  
M. Lijovic ◽  
S. Bernard ◽  
...  

Introduction: This study aims to describe the long-term functional outcome and health-related quality of life of elderly (≥65 years old) out-of-hospital cardiac arrest (OHCA) survivors in Victoria, Australia. Methods: Elderly OHCA patients who arrested between January 1st, 2010 and December 31st, 2014 were identified from the Victorian Ambulance Cardiac Arrest Registry (VACAR). Living status, Glasgow Outcome Scale-Extended (GOS-E), Euro-QoL (EQ-5D) and Twelve-item Short Form (SF-12) Health Survey were collected by telephone 12 months following the OHCA. Results: Emergency medical services attended on 14,678 elderly OHCA during the study period, 6,851 (46.7%) of which received a resuscitation attempt. Of these, 668 patients (9.8%) survived to hospital discharge. The mean age of the survivors was 75 (standard deviation (SD) 7.4) years and 504 (75.4%) were male. Eighty-five patients subsequently died within 12 months of their OHCA. A total of 483 patients were interviewed (response rate 82.9%). At 12 months, 313 responders (64.9%) were living at home without care. Most responders (n=324 (67.2%)) had a good long-term functional recovery with a GOS-E ≥7. The proportion of patients with a GOS-E≥7 progressively decreased with increasing age (65-74 years: 66.1%, 75-84 years: 53.0%,≥85 years: 27.3%). On the EQ-5D, the majority of survivors reported no problem with mobility (n=266 (55.1%)), self-care (n=403 (83.4%)), activity (n=293 (60.6%)), pain (n=335 (69.3%)) and anxiety (n=358 (74.1%)). On the SF-12, the mean mental component summary was 56.3 (SD 6.6) while the mean physical component summary was 44.7 (SD 11.4) (both measures range from 0-100). Among the 1,951 patients who arrested in a supported accommodation, 849 (43.5%) had a resuscitation attempt, and of these, 21 survived to hospital discharge (2.5%). Only eight (1.0%) of these patients were still alive 12 months after the OHCA and one survivor (0.12%) had a good functional outcome (GOS-E≥7). Conclusion: Most elderly OHCA survivors have an adequate long-term functional status and health-related quality of life. However, the likelihood of having a good functional recovery decreases with increasing age, and is rare for patients arresting in a supported accommodation.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038471
Author(s):  
Rachel M Taylor ◽  
Lorna A Fern ◽  
Julie Barber ◽  
Javier Alvarez-Galvez ◽  
Richard Feltbower ◽  
...  

ObjectivesIn England, healthcare policy advocates specialised age-appropriate services for teenagers and young adults (TYA), those aged 13 to 24 years at diagnosis. Specialist Principal Treatment Centres (PTC) provide enhanced TYA age-specific care, although many still receive care in adult or children’s cancer services. We present the first prospective structured analysis of quality of life (QOL) associated with the amount of care received in a TYA-PTCDesignLongitudinal cohort study.SettingHospitals delivering inpatient cancer care in England.Participants1114 young people aged 13 to 24 years newly diagnosed with cancer.InterventionExposure to the TYA-PTC defined as patients receiving NO-TYA-PTC care with those receiving ALL-TYA-PTC and SOME-TYA-PTC care.Primary outcomeQuality of life measured at five time points: 6, 12, 18, 24 and 36 months after diagnosis.ResultsGroup mean total QOL improved over time for all patients, but for those receiving NO-TYA-PTC was an average of 5.63 points higher (95% CI 2.77 to 8.49) than in young people receiving SOME-TYA-PTC care, and 4·17 points higher (95% CI 1.07 to 7.28) compared with ALL-TYA-PTC care. Differences were greatest 6 months after diagnosis, reduced over time and did not meet the 8-point level that is proposed to be clinically significant. Young people receiving NO-TYA-PTC care were more likely to have been offered a choice of place of care, be older, from more deprived areas, in work and have less severe disease. However, analyses adjusting for confounding factors did not explain the differences between TYA groups.ConclusionsReceipt of some or all care in a TYA-PTC was associated with lower QOL shortly after cancer diagnosis. The NO-TYA-PTC group had higher QOL 3 years after diagnosis, however those receiving all or some care in a TYA-PTC experienced more rapid QOL improvements. Receipt of some care in a TYA-PTC requires further study.


2017 ◽  
Vol 31 (6) ◽  
pp. 530-539 ◽  
Author(s):  
Véronique R. M. Moulaert ◽  
Caroline M. van Heugten ◽  
Ton P. M. Gorgels ◽  
Derick T. Wade ◽  
Jeanine A. Verbunt

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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