Long-term survival and health-related quality of life after in-hospital cardiac arrest

Marc Schluep*, Sanne Elisabeth Hoeks, Michiel Blans, Bas van den Bogaard, Ankie Koopman-van Gemert, Cees Kuijs, Chris Hukshorn, Nardo van der Meer, Marco Knook, Trudy van Melsen, René Peters, Patrick Perik, Koen Simons, Gerben Spijkers, Wytze Vermeijden, Evert Jan Wils, R. J. (Robert Jan) Stolker, H. (Rik) Endeman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

7 Citations (Scopus)
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Introduction: In-hospital cardiac arrest (IHCA) is an adverse event associated with high mortality. Because of the impact of IHCA more data is needed on incidence, outcomes and associated factors that are present prior to cardiac arrest. The aim was to assess one-year survival, patient-centred outcomes after IHCA and their associated pre-arrest factors. 

Methods: A multicentre prospective cohort study in 25 hospitals between January 1st 2017 and May 31st 2018. Patients ≥ 18 years receiving cardiopulmonary resuscitation (CPR) for IHCA were included. Data were collected using Utstein and COSCA-criteria, supplemented by pre-arrest Modified Rankin Scale (MRS, functional status) and morbidity through the Charlson Comorbidity Index (CCI). Main outcomes were survival, health-related quality of life (HRQoL, EuroQoL) and functional status (MRS) after one-year. 

Results: A total of 713 patients were included, 64.5% was male, median age was 63 years (IQR 52–72) and 72.8% had a non-shockable rhythm, 394 (55.3%) achieved ROSC, 231 (32.4%) survived to hospital discharge and 198 (27.8%) survived one year after cardiac arrest. Higher pre-arrest MRS, age and CCI were associated with mortality. At one year, patients rated HRQoL 72/100 points on the EQ-VAS and 69.7% was functionally independent. 

Conclusion: One-year survival after IHCA in this study is 27.8%, which is relatively high compared to previous studies. Survival is associated with a patient's pre-arrest functional status and morbidity. HRQoL appears acceptable, however functional rehabilitation warrants attention. These findings provide a comprehensive insight in in-hospital cardiac arrest prognosis.

Original languageEnglish
Pages (from-to)297-306
Number of pages10
Early online date14 Jul 2021
Publication statusPublished - 1 Oct 2021

Bibliographical note

Funding Information:
This study was funded by departmental funds of the participating hospitals. Licensing of the SF-12 software (€800) was funded by the ESA Air Liquide unrestricted research grant 2017, as well as printing and postage costs (approx. €300).

Publisher Copyright:
© 2021 The Author(s)


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