Quality of life after cardiac arrest - evaluation with EQ-5D

Background

Evaluation of outcome after cardiac arrest focuses mainly on survival. Survivors of cardiac arrest end up in different states of health and survival alone may not be a sensitive measure for successful cardiopulmonary resuscitation (CPR).

Objectives

To evaluate health-related quality of life (HR-QOL) of cardiac arrest survivors with EQ-5D, a generic instrument developed by the EuroQol group.

Patients and methods

From April 1997 to December 1999, all cardiac arrest adult patients admitted in a six-bed medical/surgical (ICU) of a tertiary care hospital were enrolled. At six months after ICU discharge survivors attended a follow-up interview and answered EQ-5D questionnaire. A match-control group was created choosing for each survivor of cardiac arrest two controls, with similar age range (± 3 years) and similar Apache II (± 2 Apache units), that were randomly selected among other ICU patients.

Results

From a total of 834 patients, 67 patients were admitted after cardiac arrest. Of these, 33 (49%) were discharged from ICU. From these, five patients died in the ward. Twenty-eight (42%) patients were discharged from hospital. Ten patients died after hospital discharge but before 6-month evaluation. Seven patients were not evaluated, five because they were living in distant locations, one because was in prison and another one for unknown reasons. Eleven patients attended the follow-up consultation. Two patients presented with anoxic encefalopathy with severe neurological dysfunction. A third one presented less severe anoxic neurological sequelae. Cardiac arrest survivors exhibit significantly worst quality of life only in the self-care dimension.

Conclusions

When evaluated with EQ-5D at 6 months after ICU discharge, survivors of cardiac arrest exhibit a HR-QOL similar to other ICU survivors presenting only more difficulties in the self-care dimension. These results agree with previous reports stating that CPR is frequently unsuccessful but if survival is achieved a fair good quality of life can be expected.