Nanjayya Vinodh Bhagyalakshmi, Fulcher Bentley, Nehme Emily, Neto Ary Serpa, Nichol Alistair, Kaye David M, James Cooper D, Nehme Ziad, Bernard Stephen, Pellegrino Vincent, Higgins Alisa M, Hodgson Carol L
Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Melbourne, VIC, Australia; Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia.
Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Resuscitation. 2025 May;210:110601. doi: 10.1016/j.resuscitation.2025.110601. Epub 2025 Apr 3.
To compare the long-term health-related quality of life (HRQoL) between patients receiving extracorporeal cardiopulmonary resuscitation (ECPR) and conventional cardiopulmonary resuscitation (CCPR) for out-of-hospital cardiac arrest (OHCA).
A retrospective cohort study using the Australian and New Zealand extracorporeal membrane oxygenation (EXCEL) registry for ECPR cases and the Victorian Ambulance Cardiac Arrest Registry (VACAR) for CCPR cases. All the adult patients with OHCA who had their cardiac arrest and 12-month HRQoL data recorded between July 2019 and July 2023 were eligible for inclusion. The primary outcomes were the 12-month EuroQol five-dimension (EQ-5D-5L) utility score and EuroQol visual analogue score (EQ-VAS).
There were 33/122(28%) ECPR and 1,074/8,990(12%) CCPR OHCA survivors at 12 months. Of these, 24 (73%) ECPR and 754 (70%) CCPR survivors had HRQoL data. The ECPR cohort was younger [mean(SD) 50.4(13.46) vs 60.5(14.01) yrs, p < 0.01] and more likely to have received bystander CPR [19(79%) ECPR vs 397(52%) CCPR, p < 0.001]. Both cohorts had similar proportions of males, witnessed arrests and initial shockable rhythms. Median (IQR) arrest to ROSC/ECMO time was longer in ECPR than CCPR [61(41.5-97) vs 6(2-14) minutes, p < 0.001]. The median (IQR) EQ-5D-5L utility score [0.95 (0.72-1) ECPR vs 0.96 (0.86-1) CCPR, p = 0.64] and median (IQR) EQ-VAS at 12 months [80 (64.5-90) ECPR vs 75 (60-85) CCPR, p = 0.39] were similar. There were no significant differences in the EQ-5D-5L utility scores and EQ-VAS even after adjustment for baseline imbalances.
Despite significant baseline differences between ECPR and CCPR, there were no differences in HRQoL at 12 months.
比较接受体外心肺复苏（ECPR）和传统心肺复苏（CCPR）治疗院外心脏骤停（OHCA）患者的长期健康相关生活质量（HRQoL）。
一项回顾性队列研究，使用澳大利亚和新西兰体外膜肺氧合（EXCEL）登记系统收集ECPR病例，以及维多利亚州救护车心脏骤停登记系统（VACAR）收集CCPR病例。纳入2019年7月至2023年7月期间记录了心脏骤停及12个月HRQoL数据的所有成年OHCA患者。主要结局指标为12个月的欧洲五维健康量表（EQ-5D-5L）效用评分和欧洲五维健康量表视觉模拟评分（EQ-VAS）。
12个月时，有33/122（28%）例ECPR和1,074/8,990（12%）例CCPR的OHCA幸存者。其中，24例（73%）ECPR和754例（70%）CCPR幸存者有HRQoL数据。ECPR队列患者更年轻[平均（标准差）50.4（13.46）岁对60.5（14.01）岁，p<0.01]，且更有可能接受旁观者心肺复苏[19例（79%）ECPR对397例（52%）CCPR，p<0.001]。两个队列的男性比例、目击心脏骤停和初始可电击心律比例相似。ECPR组从心脏骤停至恢复自主循环/启动体外膜肺氧合的中位（四分位间距）时间长于CCPR组[61（41.5-97）分钟对6（2-14）分钟，p<0.001]。12个月时的中位（四分位间距）EQ-5D-5L效用评分[ECPR组为0.95（0.72-1）对CCPR组为0.96（0.86-1），p=0.64]和中位（四分位间距）EQ-VAS[ECPR组为80（64.5-9）对CCPR组为75（60-85），p=0.39]相似。即使在对基线不平衡进行调整后，EQ-5D-5L效用评分和EQ-VAS也无显著差异。
尽管ECPR和CCPR之间存在显著的基线差异，但12个月时的HRQoL无差异。
