Rossberg Michelle, Freund Anne, Thevathasan Tharusan, Skurk Carsten, Koenig Inke R, Vens Maren, Grube Hanna, Sandig Frank, Klinge Kathrin, Akin Ibrahim, Fuernau Georg, Hassager Christian, Zeymer Uwe, Preusch Michael R, Graf Tobias, Jobs Alexander, de Waha Suzanne, Thiele Holger, Poess Janine, Desch Steffen
Department of Internal Medicine/Cardiology, Heart Center Leipzig at Leipzig University, Struempellstraße 39, 04289 Leipzig, Germany.
Leipzig Heart Science, Russenstraße 69a, 04289 Leipzig, Germany.
Eur Heart J Acute Cardiovasc Care. 2025 Jun 25. doi: 10.1093/ehjacc/zuaf093.
The TOMAHAWK trial compared immediate coronary angiography with a delayed/selective strategy in 554 resuscitated patients with out-of-hospital cardiac arrest (OHCA) without ST-segment elevations. Mortality did not differ significantly between the two groups. In addition to survival, health-related quality of life (HRQoL) is a key outcome parameter for OHCA patients.
The analysis included 169 survivors from the TOMAHAWK trial who completed both the 6-month and 12-month follow-up (6M-FU/12M-FU). HRQoL was assessed using a questionnaire based on the EuroQoL-5D-3L. This tool includes a visual analogue scale (EQ-VAS) ranging from 0 to 100 (worst to best imaginable subjective health) and a descriptive system with five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
No relevant differences were found between patients in the immediate angiography group and those in the delayed/selective angiography group regarding EQ-VAS scores at 6M-FU (70 ± 21 vs. 74 ± 18) and 12M-FU (72 ± 19 vs. 74 ± 17). Patients reported the most problems with usual activities (33% and 38%, respectively), and the fewest limitations in self-care (18% and 17%, respectively) at 6M-FU. Women reported more problems than men in all five dimensions. Elderly patients (≥65 years) were more likely than younger OHCA survivors to indicate limitations in mobility, self-care, usual activities, and pain/discomfort.
OHCA survivors of the TOMAHAWK trial rated their HRQoL 6 and 12 months after the event as relatively good, but there were notable differences between women and men and between younger and elderly patients. The angiography strategy did not affect HRQoL. www.ClinicalTrials.gov : NCT02750462.
TOMAHAWK试验比较了554例院外心脏骤停（OHCA）复苏后无ST段抬高患者立即进行冠状动脉造影与延迟/选择性策略的效果。两组患者的死亡率无显著差异。除了生存情况外，健康相关生活质量（HRQoL）是OHCA患者的关键结局参数。
分析纳入了TOMAHAWK试验中的169名幸存者，他们完成了6个月和12个月的随访（6M-FU/12M-FU）。使用基于欧洲五维健康量表（EuroQoL-5D-3L）的问卷评估HRQoL。该工具包括一个从0到100的视觉模拟量表（EQ-VAS）（从最差到最佳主观健康状况）和一个包含五个维度的描述系统：活动能力、自我护理、日常活动、疼痛/不适和焦虑/抑郁。
在6个月随访（6M-FU）时（70±21 vs. 74±18）和12个月随访（12M-FU）时（72±19 vs. 74±17），立即造影组患者与延迟/选择性造影组患者的EQ-VAS评分无显著差异。患者报告在6个月随访时日常活动方面的问题最多（分别为33%和38%），自我护理方面的限制最少（分别为18%和17%）。在所有五个维度中，女性报告的问题比男性多。老年患者（≥65岁）比年轻的OHCA幸存者更有可能表示在活动能力、自我护理、日常活动和疼痛/不适方面存在限制。
TOMAHAWK试验中的OHCA幸存者在事件发生后6个月和12个月对其HRQoL的评价相对较好，但男女之间以及年轻和老年患者之间存在显著差异。造影策略不影响HRQoL。ClinicalTrials.gov：NCT02750462。
