Ghassemi Kaitlyn, Reinier Kyndaron, Chugh Sumeet S, Norby Faye L
Western University of Health Sciences College of Osteopathic Medicine of the Pacific, United States.
Center for Cardiac Arrest Prevention, Smidt Heart Institute, Cedars-Sinai Health System, Los Angeles, CA, United States.
Resusc Plus. 2024 Aug 6;19:100736. doi: 10.1016/j.resplu.2024.100736. eCollection 2024 Sep.
Survival after out-of-hospital cardiac arrest (OHCA) remains low, although the number of survivors is increasing, and survivors are living longer. With increasing long-term survival, there is a need to understand health-related quality of life (HRQoL) measures. Although there are current recommendations for measuring HRQoL in OHCA survivors, there is significant heterogeneity in assessment timing and the measurement tools used to quantify HRQoL outcomes, making the interpretation and comparison of HRQoL difficult. Identifying groups of survivors of OHCA with poor HRQoL measures could be used for targeted intervention studies. Sex differences in OHCA resuscitation characteristics, post-cardiac arrest treatment, and short-term survival outcomes are well-documented, although variability in study methods and statistical adjustments appear to affect study results and conclusions. It is unclear whether sex differences exist in HRQoL among OHCA survivors and if study methods and statistical adjustment for patient characteristics or arrest circumstances impact the results. In this narrative review article, we provide an overview of the assessment of HRQoL and the main domains of HRQoL. We summarize the literature regarding sex differences in HRQoL in OHCA survivors. Few multivariable-adjusted studies reported HRQoL sex differences and there was significant heterogeneity in study size, timing of assessment, and domains measured and reported. What is reported suggests females have worse HRQoL than males, especially in the domains of physical function and mental health, but results should be interpreted with caution. Lastly, we discuss the challenges of a non-uniform approach to measurement and future directions for assessing and improving HRQoL in OHCA survivors.
院外心脏骤停（OHCA）后的生存率仍然很低，尽管幸存者的数量在增加，且幸存者的存活时间也在延长。随着长期生存率的提高，有必要了解与健康相关的生活质量（HRQoL）指标。尽管目前有关于测量OHCA幸存者HRQoL的建议，但在评估时间和用于量化HRQoL结果的测量工具方面存在显著异质性，这使得HRQoL的解释和比较变得困难。识别HRQoL指标较差的OHCA幸存者群体可用于针对性干预研究。OHCA复苏特征、心脏骤停后治疗及短期生存结果中的性别差异已有充分记录，尽管研究方法和统计调整的差异似乎会影响研究结果和结论。目前尚不清楚OHCA幸存者的HRQoL是否存在性别差异，以及针对患者特征或骤停情况的研究方法和统计调整是否会影响结果。在这篇叙述性综述文章中，我们概述了HRQoL的评估及HRQoL的主要领域。我们总结了关于OHCA幸存者HRQoL性别差异的文献。很少有多变量调整研究报告HRQoL的性别差异，且在研究规模、评估时间以及测量和报告的领域方面存在显著异质性。所报告的内容表明女性的HRQoL比男性差，尤其是在身体功能和心理健康领域，但对结果的解释应谨慎。最后，我们讨论了测量方法不一致所带来的挑战以及评估和改善OHCA幸存者HRQoL的未来方向。
