Life after survival: long-term daily life functioning and quality of life of patients with hypoxic brain injury as a result of a cardiac arrest

Introduction. Chronic post-anoxic myoclonus, also known as Lance-Adams syndrome, may develop following hypoxic brain injury, and is resistant to pharmacological therapy. Case report. The patient we presented developed post-anoxic action myoclonus with severe, completely incapacitating myoclonic jerks. Myoclonus did not respond to the treatment with commonly used agents, i.e. valproate and clonazepam alone or in combination. Improvement of the action myoclonus was observed only after adding levetiracetam. Conclusion. Although Lance-Adams syndrome may not be fully curable at this point, levetiracetam appears to be a promising agent that can significantly improve functional level and overall quality of life of patients with this disorder.

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Long-term Outcome After Survival of a Cardiac Arrest: A Prospective Longitudinal Cohort Study

Neurorehabilitation and Neural Repair ◽

10.1177/1545968317697032 ◽

2017 ◽

Vol 31 (6) ◽

pp. 530-539 ◽

Cited By ~ 20

Author(s):

Véronique R. M. Moulaert ◽

Caroline M. van Heugten ◽

Ton P. M. Gorgels ◽

Derick T. Wade ◽

Jeanine A. Verbunt

Keyword(s):

Quality Of Life ◽

Cardiac Arrest ◽

Cohort Study ◽

Anxiety And Depression ◽

Term Outcome ◽

Long Term Outcome ◽

Prospective Longitudinal ◽

Prospective Longitudinal Cohort

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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Focusing on recovery: Long-term health-related quality-of-life of out-of-hospital cardiac arrest survivors

Resuscitation ◽

10.1016/j.resuscitation.2021.03.002 ◽

2021 ◽

Vol 162 ◽

pp. 428-430

Author(s):

Joshua R. Lupton ◽

Mohamud R. Daya

Keyword(s):

Quality Of Life ◽

Cardiac Arrest ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

Hospital Cardiac Arrest

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Long-term Quality of Life After Decompressive Craniectomy in Severe Traumatic Brain Injury and Stroke

10.21203/rs.3.rs-626876/v1 ◽

2021 ◽

Author(s):

Alex Vicino ◽

Philippe Vuadens ◽

Bertrand Léger ◽

Charles Benaim

Keyword(s):

Quality Of Life ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Acute Phase ◽

Decompressive Craniectomy ◽

Severe Traumatic Brain Injury ◽

Full Time ◽

Stroke Patients

Abstract PurposeDecompressive craniectomy (DC) can rapidly reduce intracranial pressure and save lives in the acute phase of severe traumatic brain injury (TBI) or stroke, but little is known about the long-term outcome after DC. We evaluated quality of life (QoL) a few years after DC for severe TBI/stroke.MethodsThe following data were collected for stroke/TBI patients hospitalized for neurorehabilitation after DC: 1) at discharge, motor and cognitive sub-scores of the Functional Independence Measure (motor-FIM [score 13-91] and cognitive-FIM [score 5-35]) and 2) more than 4 years after discharge, the QOLIBRI health-related QoL (HR-QoL) score (0-100; <60 representing low or impaired QoL) and the return to work (RTW: 0%, partial, 100%)ResultsWe included 88 patients (66 males, median age 38 [interquartile range 26.3-51.0], 65 with TBI/23 stroke); 46 responded to the HR-QoL questionnaire. Responders and non-responders had similar characteristics (age, sex, functional levels upon discharge). Median motor-FIM and cognitive-FIM scores were 85/91 and 27/35, with no significant difference between TBI and stroke patients. Long-term QoL was borderline low for TBI patients and within normal values for stroke patients (score 58.0[42.0-69.0] vs. 67.0[54.0-81.5], p=0.052). RTW was comparable between the groups (62% full time).ConclusionWe already knew that DC can save the lives of TBI or stroke patients in the acute phase and this study suggests that their long-term quality of life is generally quite acceptable.

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Craniectomy and Craniotomy in Traumatic Brain Injury: A Propensity-Matched Analysis of Long-Term Functional and Quality of Life Outcomes

World Neurosurgery ◽

10.1016/j.wneu.2018.07.124 ◽

2018 ◽

Vol 118 ◽

pp. e974-e981 ◽

Cited By ~ 1

Author(s):

Michael L. Kelly ◽

Berje Shammassian ◽

Mary Jo Roach ◽

Charles Thomas ◽

Amy K. Wagner

Keyword(s):

Quality Of Life ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Life Outcomes ◽

Quality Of Life Outcomes

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A history of unemployment or sick leave influences long-term functioning and health-related quality-of-life after severe traumatic brain injury

Brain Injury ◽

10.3109/02699052.2013.865274 ◽

2013 ◽

Vol 28 (3) ◽

pp. 328-335 ◽

Cited By ~ 5

Author(s):

Trandur Ulfarsson ◽

Åsa Lundgren-Nilsson ◽

Christian Blomstrand ◽

Michael Nilsson

Keyword(s):

Quality Of Life ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Sick Leave ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

History Of

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Quality of life in patients with mild acute brain injury and their carers’ needs in Greece

Clinical Nursing Studies ◽

10.5430/cns.v9n1p39 ◽

2021 ◽

Vol 9 (1) ◽

pp. 39

Author(s):

Evgenia Stasinopoulou ◽

Margarita Giannakopoulou ◽

Georgios Fildisis ◽

Maria Kalafati ◽

Chryssoula Leomonidou

Keyword(s):

Quality Of Life ◽

Brain Injury ◽

Social Life ◽

Well Being ◽

Acute Brain Injury ◽

Support Network ◽

Family Needs ◽

Rehabilitation Centers

Background: Investigating quality of life (QoL) is of crucial importance for the scientific community as it could function not only as an indicator of prognosis and post-traumatic clinical and psychological changes in patients who have suffered from acute brain injury (ABI), but also as an indicator of the effectiveness of their treatment and social rehabilitation. In addition, it can highlight changes in the carer’s health, social life and well-being. This study examined the QoL of patients following ABI and the needs of their carers.Material and methodology: This study was conducted in patients suffering from ABI, who were admitted to the General Hospital of Attica “KAT” and to the National Rehabilitation Center and on their carers. Data collection including demographics and Quality of Life After Brain Injury Questionnaire (QOLIBRI) and the Family Needs Questionnaire (FNQ) was performed during patients’ rehabilitation, while six months after release, a follow-up survey was conducted using the same questionnaires. Statistical analysis of data was performed using SPSS.Results: We analysed 50 patients with mild ABI (GCS ≥ of 13/15) during rehabilitation and six months after release and found that their QoL improves and is positively related to improvement of health status (i.e. in terms of thinking ability, QoL improves from r = 2.33, p < .01 to r = 3.37, p < .001). We also found that “Age” has the greatest impact on the patient’s progress for recovery and the general QoL after ABI (r = -0.423, p < .01). In addition, it was found that carers of patients with ABI are confronted with the burden of care, while they record both fulfilled and unmet needs regarding their individual needs (i.e. only for 30% of the sample the need for help in preparing them for the worst is met).Conclusions: Our study confirms previous findings that underline that ABI has a major impact on QoL of both patients and their carers providing them with long-term daily care. Although it has been found that over time there is an improvement in the QoL of patients with ABI, the absence of an official support network for carers from public health system, hospitals and rehabilitation centers may adversely affect the QoL of patients and their carers. Therefore, more structured, long-term family-wide monitoring and support is needed, focusing on identifying those at risk of social isolation and incomplete social networking.

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Abstract 10394: Long-Term Functional and Quality-of-Life Outcomes of Cardiac Arrest Survivors Stratified by Shock Provider: A 10 Year Retrospective Study

Circulation ◽

10.1161/circ.144.suppl_2.10394 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Brian A Haskins ◽

Ziad Nehme ◽

Emily Andrew ◽

Stephen Bernard ◽

Peter Cameron ◽

...

Keyword(s):

Quality Of Life ◽

Cardiac Arrest ◽

Functional Recovery ◽

Short Form ◽

First Responders ◽

Assessment Tools ◽

Related Quality ◽

Health Related

Introduction: To assess the long-term functional recovery and health related quality-of-life (HRQoL) outcomes for out-of-hospital cardiac arrest (OHCA) survivors stratified by shock provider. Methods: We included adult OHCA in initial shockable rhythms between 2010-2019. Those surviving to 12 months post arrest were invited to participate in telephone interviews to identify functional recovery and HRQoL outcomes, using the following assessment tools, Glasgow Outcome Scale-Extended (GOS-E), EuroQol-5D (EQ-5D), and 12-Item Short Form (SF-12). Results: Of the 1,581 patients surviving to 12 months, 1,325 (85.5%) responded to the interviews, of these, 227 (17.1%) and 144 (10.9%) were initially shocked by bystanders and first responders, respectively. A higher proportion of patients shocked by bystanders were located in public (p<0.001), received bystander CPR (p<0.001) and received initial defibrillation faster from time of collapse (P<0.001). Survivors receiving bystander defibrillation reported higher rates of living at home without care (p=0.004), upper good recovery (GOS-E) (p=0.008) and EQ-5D index score of 1 (perfect health) (p=0.023). After adjustment, bystander defibrillation was associated with a 64% increase in the odds of an EQ-5D current Visual Analogue Scale ≥ 80 (AOR 1.64, 95%CI: 1.17-2.31; p=0.004) and a 45% increase in the odds of a good functional recovery (GOS-E ≥ 7) (AOR 1.45, 95% CI: 1.02-2.06; p=0.037), than those initially shocked by paramedics. No improvement in adjusted outcomes were observed for survivors initially defibrillated by first responders. Conclusion: Patients receiving bystander defibrillation reported better functional recovery and HRQol outcomes at 12 months compared to those defibrillated by first responders and paramedics.

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