TY - JOUR
T1 - Health-related quality of life one year after refractory cardiac arrest treated with conventional or extracorporeal CPR; a secondary analysis of the INCEPTION-trial
AU - van de Koolwijk, Anina F.
AU - Delnoij, Thijs S.R.
AU - Suverein, Martje M.
AU - Essers, Brigitte A.B.
AU - Hermanides, Renicus C.
AU - Otterspoor, Luuk C.
AU - Elzo Kraemer, Carlos V.
AU - Vlaar, Alexander P.J.
AU - van der Heijden, Joris J.
AU - Scholten, Erik
AU - den Uil, Corstiaan A.
AU - Dos Reis Miranda, Dinis
AU - Akin, Sakir
AU - de Metz, Jesse
AU - van der Horst, Iwan C.C.
AU - Winkens, Bjorn
AU - Maessen, Jos G.
AU - Lorusso, Roberto
AU - van de Poll, Marcel C.G.
AU - INCEPTION-investigators
N1 - Funding Information:
This paper represents independent research, financially supported by Getinge and ZonMw, to conduct the original trial.
Publisher Copyright:
© 2024 The Author(s)
PY - 2024/9/1
Y1 - 2024/9/1
N2 - Background: Prospective, trial-based data comparing health-related quality of life (HRQoL) in patients surviving out-of-hospital cardiac arrest (OHCA) through extracorporeal cardiopulmonary resuscitation (ECPR) or conventional CPR (CCPR) are scarce. We aimed to determine HRQoL during 1-year after refractory OHCA in patients treated with ECPR and CCPR. Methods: We present a secondary analysis of the multicenter INCEPTION-trial, which studied the effectiveness of ECPR versus CCPR in patients with refractory OHCA. HRQoL was prospectively assessed using the EQ-5D-5L questionnaire. Poor HRQoL was pragmatically defined as an EQ-5D-5L health utility index (HUI) > 1 SD below the age-adjusted norm. We used mixed linear models to assess the difference in HRQoL over time and univariable analyses to assess factors potentially associated with poor HRQoL. Results: A total of 134 patients were enrolled, and hospital survival was 20% (27 patients). EQ-5D-5L data were available for 25 patients (5 ECPR and 20 CCPR). One year after OHCA, the estimated mean HUI was 0.73 (0.05) in all patients, 0.84 (0.12) in ECPR survivors, and 0.71 (0.05) in CCPR survivors (p-value 0.31). Eight (32%) survivors had a poor HRQoL. HRQoL was good in 17 (68%) patients, with 100% in ECPR survivors versus 60% in CCPR survivors (p-value 0.14). Conclusion: One year after refractory OHCA, 68% of the survivors had a good HRQoL. We found no statistically significant difference in HRQoL one year after OHCA in patients treated with ECPR compared to CCPR. However, numerical differences may be clinically relevant in favor of ECPR.
AB - Background: Prospective, trial-based data comparing health-related quality of life (HRQoL) in patients surviving out-of-hospital cardiac arrest (OHCA) through extracorporeal cardiopulmonary resuscitation (ECPR) or conventional CPR (CCPR) are scarce. We aimed to determine HRQoL during 1-year after refractory OHCA in patients treated with ECPR and CCPR. Methods: We present a secondary analysis of the multicenter INCEPTION-trial, which studied the effectiveness of ECPR versus CCPR in patients with refractory OHCA. HRQoL was prospectively assessed using the EQ-5D-5L questionnaire. Poor HRQoL was pragmatically defined as an EQ-5D-5L health utility index (HUI) > 1 SD below the age-adjusted norm. We used mixed linear models to assess the difference in HRQoL over time and univariable analyses to assess factors potentially associated with poor HRQoL. Results: A total of 134 patients were enrolled, and hospital survival was 20% (27 patients). EQ-5D-5L data were available for 25 patients (5 ECPR and 20 CCPR). One year after OHCA, the estimated mean HUI was 0.73 (0.05) in all patients, 0.84 (0.12) in ECPR survivors, and 0.71 (0.05) in CCPR survivors (p-value 0.31). Eight (32%) survivors had a poor HRQoL. HRQoL was good in 17 (68%) patients, with 100% in ECPR survivors versus 60% in CCPR survivors (p-value 0.14). Conclusion: One year after refractory OHCA, 68% of the survivors had a good HRQoL. We found no statistically significant difference in HRQoL one year after OHCA in patients treated with ECPR compared to CCPR. However, numerical differences may be clinically relevant in favor of ECPR.
KW - Extracorporeal cardiopulmonary resuscitation
KW - Health-related quality of life
KW - Out-of-hospital cardiac arrest
KW - Refractory arrest
U2 - 10.1016/j.resplu.2024.100669
DO - 10.1016/j.resplu.2024.100669
M3 - Article
SN - 2666-5204
VL - 19
JO - Resuscitation Plus
JF - Resuscitation Plus
M1 - 100669
ER -