Life after Survival: Long term daily functioning and quality of life after an out-of-hospital cardiac arrest

Background: Information about long-term consequences of cardiac arrest is sparse. Because the survival late is expected to increase, better knowledge of long-term functioning and quality of survival is essential. Objectives: To determine the level of functioning of out-of-hospital cardiac arrest Survivors 1-6 years later, and to evaluate the predictive value of medical variables oil long-term functioning. Methods: A retrospective cohort study including 63 survivors of an out-of-hospital cardiac arrest admitted to a Dutch University hospital between 2001 and 2006. Participants received a questionnaire by post. Primary outcome measures were: participation in Society (Community Integration Questionnaire) and quality of life (SF-36). Secondary outcome Measures were: physical, cognitive and emotional impairment, daily functioning and caregiver strain. Statistical analyses included multiple regression analyses. Results: On average 3 years post-cardiac arrest, 74% of the patients experienced a low participation level in society compared with the general population. Over 50% reported severe fatigue, 38% feelings of anxiety and/or depression and 24% a decreased quality of life. Caregivers reported stress related responses, feelings of anxiety and lower quality of life. Seventeen percent of the caregivers reported high caregiver strain, which was associated with the patient's level of functioning. Gender, age, percutaneous coronary intervention (PCI) and therapeutic hypothermia contributed to outcome on at least one domain of long-term functioning. Conclusions: After surviving an out-of-hospital cardiac arrest, many patients and partners encounter extensive impairments in their level of functioning and quality of life. Gender, age, PCI and therapeutic hypothermia are associated with differences in long-term functioning of patients.