Health-Related Quality of Life Is Better for Cardiac Arrest Survivors Who Received Citizen Cardiopulmonary Resuscitation

Abstract

Background-This study evaluated the prehospital factors associated with better health-related quality of life for survivors of out-of-hospital cardiac arrest. Methods and Results-This prospective, 20-community, cohort study involved consecutive, adult out-of-hospital cardiac arrest patients who survived to 1 year. Patients were contacted by telephone and evaluated for the Health Utilities Index Mark III (HUI3), which describes health as a utility score on a scale from 0 (dead) to 1.0 (perfect health). The 8091 cardiac arrest patients had overall survival rates of 5.2% to hospital discharge and 4.0% to 1 year. We successfully contacted and evaluated 268 of 316 (84.8%) of known 1-year survivors. The median HUI3 score was 0.80 (interquartile range, 0.50 to 0.97), which compares well with age-adjusted values for the general population (0.83). Logistic regression identified 2 factors independently associated with very good quality of life (HUI3 Ͼ0.90) and their odds ratios (95% CIs), as follows: age 80 years or older, 0.3 (0.1 to 0.84), and citizen-initiated cardiopulmonary resuscitation (CPR), 2.0 (1.2 to 3.4) (Hosmer-Lemeshow goodness-of-fit statistic, 0.74). Conclusions-This study is the largest ever conducted for out-of-hospital cardiac arrest survivors, clearly shows that these patients have good quality of life, and is the first to demonstrate that citizen-initiated CPR is strongly and independently associated with better quality of life. These results emphasize the importance of optimizing community citizen CPR readiness. Given the low rate of citizen-initiated CPR in many communities, we believe that local and national initiatives should vigorously promote the practice of bystander CPR.

What Are the Etiology and Epidemiology of Out‐of‐hospital Pediatric Cardiopulmonary Arrest in Ontario, Canada?

“…[17][18][19][20][21][22][23][24] It is the largest controlled outof-hospital study ever conducted to evaluate the impact of advanced life support (ALS) programs on adult chest pain, major trauma, respiratory disease, and cardiopulmonary arrest.…”

Use of implantable cardioverter defibrillators after out-of-hospital cardiac arrest: a prospective follow-up study

“…However, poor quality of life of survivors is unlikely to explain the low implant rate, since it has been shown that most survivors of cardiac arrest have acceptable functional status 18 and health-related quality of life. [19][20][21] Finally, the low insertion rate may be attributed in part to a lag in physicians learning about the effectiveness of ICD implantation, since reports of clinical trials supporting this therapy were first published in 1997. [3][4][5] This explanation is supported by our observation of a trend toward an increase in ICD insertion in more recent years.…”

Inter Association Task Force Recommendations on Emergency Preparedness andManagement of Sudden Cardiac Arrest in High School andCollege Athletic Programs: A Consensus Statement

“…Many victims are in pulseless electric activity or asystole for several minutes after defibrillation, and CPR is needed to provide perfusion. [21][22][23] Unfortunately, bystander CPR is initiated in less than one third of cases of witnessed SCA, 24,25 and, if initiated, more than 40% of chest compressions are of insufficient quality. 26 These deficiencies illustrate the tremendous need for increased public education and training in CPR.…”