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心脏骤停成功复苏后的认知功能与生活质量

Cognitive function and quality of life after successful resuscitation from cardiac arrest.

作者信息

Beesems Stefanie G, Wittebrood Kim M, de Haan Rob J, Koster Rudolph W

机构信息

Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.

Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands.

出版信息

Resuscitation. 2014 Sep;85(9):1269-74. doi: 10.1016/j.resuscitation.2014.05.027. Epub 2014 Jun 6.

Abstract

BACKGROUND

Studies on out-of-hospital cardiac arrest (OHCA) use overall performance category (OPC)/cerebral performance category (CPC) as outcome. We studied quality of life, neuro-cognitive functioning and independency in daily life of patients and strain of caregivers 6-12 months after cardiac arrest.

METHODS

Two hundred and twenty patients (>18 year) who survived 6-12 months after OHCA and relatives were interviewed by telephone with validated questionnaires (Short-form Health Survey) (SF-12), Modified Rankin Scale (MRS), telephonic interview cognitive status (TICS) and Caregiver Strain Index (CSI) and compared with OPC and CPC at discharge. SF-12 of elderly (≥80 years) was compared to an open Dutch population of ≥80 years.

RESULTS

Of all patients, 45% had normal physical and 90% had normal mental SF-12. Eighty-one percent had a normal MRS (MRS≤2). Eighty-four percent had normal TICS. Compared to the reference population, elderly scored 40.5 on the mental physical [corrected] and 53.2 on the physical mental [corrected] SF-12, while the reference population scored 38.1 (θ=0.20) and 54.4 (θ=-0.15), respectively, (n.s.) Of the patients with OPC≤2 and CPC≤2 at discharge 15% scored MRS 3-5 and 15% abnormal TICS at follow-up, respectively. Ninety-two percent of all patients gave their quality of life a value of ≥6 (maximum 10). Patients treated with hypothermia scored on most health outcomes similar to those who did not need such treatment. Sixteen percent of caregivers experienced strain, correlating significantly with TICS of patients.

CONCLUSION

The great majority of survivors have normal functioning and cognition 6-12 months after OHCA. Functional and neuro-cognitive telephonic tests 6-12 months after OHCA are simple and better reflect patients functioning at home than OPC/CPC at discharge.

摘要

背景

院外心脏骤停(OHCA)的研究将总体表现类别(OPC)/脑功能表现类别(CPC)作为研究结果。我们对心脏骤停后6至12个月患者的生活质量、神经认知功能、日常生活自理能力以及照顾者的负担进行了研究。

方法

通过电话对220名心脏骤停后存活6至12个月的患者(年龄>18岁)及其亲属进行访谈,使用经过验证的问卷(简短健康调查问卷)(SF-12)、改良Rankin量表(MRS)、电话访谈认知状态(TICS)和照顾者负担指数(CSI),并与出院时的OPC和CPC进行比较。将老年患者(≥80岁)的SF-12与荷兰≥80岁的开放人群进行比较。

结果

所有患者中,45%的患者身体功能正常,90%的患者精神功能正常(SF-12)。81%的患者MRS正常(MRS≤2)。84%的患者TICS正常。与参考人群相比,老年患者在精神-身体(校正后)SF-12上得分为40.5,在身体-精神(校正后)SF-12上得分为53.2,而参考人群分别得分为38.1(θ=0.20)和54.4(θ=-0.15),(无显著性差异)。出院时OPC≤2且CPC≤2的患者中,分别有15%在随访时MRS评分为3 - 5,15%的患者TICS异常。92%的患者给自己的生活质量打分为≥6(满分10分)。接受低温治疗的患者在大多数健康指标上的得分与不需要此类治疗的患者相似。16%的照顾者感到有负担,这与患者的TICS显著相关。

结论

绝大多数心脏骤停幸存者在OHCA后6至12个月功能和认知正常。OHCA后6至12个月的功能和神经认知电话测试简单,比出院时的OPC/CPC更能反映患者在家中的功能状况。

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