Treml Benedikt, Eckhardt Christine, Oberleitner Christoph, Ploner Thomas, Rugg Christopher, Radovanovic Spurnic Aleksandra, Rajsic Sasa
Universitätsklinik für Anästhesie und Intensivmedizin, Medizinische Universität Innsbruck, Anichstraße 35, 6020, Innsbruck, Österreich.
Universitätsklinik für Innere Medizin, Medizinische Universität Innsbruck, 6020, Innsbruck, Österreich.
Anaesthesiologie. 2024 Jul;73(7):454-461. doi: 10.1007/s00101-024-01423-3. Epub 2024 May 31.
Cardiac arrest is a life-threatening condition requiring urgent medical care and is one of the leading causes of death worldwide. Given that in-hospital cardiac arrest (IHCA) is still poorly investigated, data on health-associated quality of life thereafter remains scarce. The available evidence is mostly transferred from out-of-hospital cardiac arrest studies, but the epidemiology and determinants of success might be different. The aim of the study was to investigate the change in the quality of life after in-hospital cardiac arrest and to identify potential risk factors for a poor outcome.
This retrospective analysis of data and prospective evaluation of quality of life included all patients surviving an IHCA and being treated by the emergency medical team between 2010 and 2020. The primary endpoint of the study was the quality of life after IHCA at the reference date. Secondary endpoints covered determination of risk factors and predictors of poor outcome after in-hospital cardiopulmonary resuscitation.
In total 604 patients were resuscitated within the period of 11 years and 61 (10%) patients survived until the interview took place. Finally, 48 (79%) patients fulfilled the inclusion criteria and 31 (65%) were included in the study. There was no significant difference in the quality of life before and after cardiac arrest (EQ-5D-5L utility 0.79 vs. 0.78, p = 0.567) and in the EQ-5D-5L visual analogue scale (VAS) score.
The quality of life before and after IHCA in survivors was good and comparable. The quality of life was mostly affected by reduced mobility and anxiety/depression. Future studies with larger patient samples should focus on potentially modifiable factors that could prevent, warn, and limit the consequences of in-hospital cardiac arrest. Moreover, research on outcomes of IHCA should include available tools for the quality of life assessment.
心脏骤停是一种危及生命的状况,需要紧急医疗护理,是全球主要死因之一。鉴于院内心脏骤停(IHCA)的研究仍不充分,此后与健康相关的生活质量数据仍然匮乏。现有证据大多从院外心脏骤停研究中转来,但成功的流行病学和决定因素可能有所不同。本研究的目的是调查院内心脏骤停后生活质量的变化,并确定不良结局的潜在风险因素。
这项对数据的回顾性分析和对生活质量的前瞻性评估纳入了2010年至2020年间所有在院内心脏骤停后存活并由急诊医疗团队治疗的患者。该研究的主要终点是参考日期时院内心脏骤停后的生活质量。次要终点包括确定院内心肺复苏后不良结局的风险因素和预测因素。
在11年期间,共有604例患者接受了心肺复苏,61例(10%)患者存活至访谈时。最后,48例(79%)患者符合纳入标准,31例(65%)纳入研究。心脏骤停前后的生活质量(EQ-5D-5L效用值0.79对0.78,p = 0.567)以及EQ-5D-5L视觉模拟量表(VAS)评分均无显著差异。
幸存者院内心脏骤停前后的生活质量良好且相当。生活质量主要受行动能力下降和焦虑/抑郁的影响。未来对更大患者样本的研究应关注可能可改变的因素,这些因素可预防、预警并限制院内心脏骤停的后果。此外,院内心脏骤停结局的研究应包括现有的生活质量评估工具。