von Auenmüller I, Christ M, Brand M, Dierschke W, Trappe H-J
Medizinische Klinik II (Schwerpunkt Kardiologie und Angiologie), Marien Hospital Herne, Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland.
Med Klin Intensivmed Notfmed. 2019 Apr;114(3):252-257. doi: 10.1007/s00063-018-0403-4. Epub 2018 Jan 26.
Survival rate after out-of-hospital cardiac arrest (OHCA) is increasing. However, there is a lack of data concerning long-term quality of life of affected patients.
This study aims to investigate the psychological effects of out-of-hospital cardiopulmonary resuscitation.
All patients who were admitted to our hospital after OHCA between 01 January 2008 and 30 June 2015 and could be discharged in good neurological condition were asked to fill out the Impact of Event Scale-Revised (IES-R) and 36-Item Short Form Health Survey (SF-36). For statistical analysis, the mean, standard deviation and student's t‑test were used (level of significance p < 0.05).
Of 280 OHCA survivors, 56 patients (20.0%) were discharged from the hospital in good neurological condition. Of those, 20 patients (35.7%) were willing to participate in this study, among them 11 women and 9 men. Compared to the cohort of the German normative data, the results of the SF-36 questionnaire of OHCA survivors showed significantly lower values in all SF-36 subscales and also for the summary scores. There was no significant difference compared to patients with myocardial infarction. Average values of the IES-R subscales for intrusion and avoidance were 9.9 ± 9.3 and 9.7 ± 7.7, respectively, and 11.3 ± 7.4 for hyperarousal. Calculations indicated the suspected diagnosis of posttraumatic stress disorder in 2 of the 20 patients (10%).
Even in patients who could be discharged from the hospital after OHCA in good neurological condition, the quality of life is significantly lower compared to the standard population but not compared to patients with myocardial infarction. The data also suggest that a relevant number of patients after OHCA is affected by posttraumatic stress disorder. Further research efforts on optimization of post-resuscitation care should not only focus on survival rates but also on improving quality of life.
院外心脏骤停（OHCA）后的生存率正在提高。然而，关于受影响患者长期生活质量的数据却很缺乏。
本研究旨在调查院外心肺复苏的心理影响。
所有在2008年1月1日至2015年6月30日期间因院外心脏骤停入院且神经功能良好可出院的患者，均被要求填写事件影响量表修订版（IES-R）和36项简短健康调查（SF-36）。统计分析采用均值、标准差和学生t检验（显著性水平p<0.05）。
在280名院外心脏骤停幸存者中，56名患者（20.0%）神经功能良好出院。其中，20名患者（35.7%）愿意参与本研究，包括11名女性和9名男性。与德国标准数据队列相比，院外心脏骤停幸存者的SF-36问卷结果显示，所有SF-36子量表及总分均显著较低。与心肌梗死患者相比无显著差异。IES-R子量表中侵入和回避的平均值分别为9.9±9.3和9.7±7.7，高唤醒为11.3±7.4。计算表明，20名患者中有2名（10%）疑似诊断为创伤后应激障碍。
即使是那些院外心脏骤停后神经功能良好可出院的患者，其生活质量与标准人群相比仍显著较低，但与心肌梗死患者相比则不然。数据还表明，相当数量的院外心脏骤停后患者受到创伤后应激障碍的影响。关于优化复苏后护理的进一步研究不应只关注生存率，还应关注提高生活质量。
