[Quality of life and posttraumatic stress disorder after out-of-hospital cardiac arrest]

Med Klin Intensivmed Notfmed. 2019 Apr;114(3):252-257. doi: 10.1007/s00063-018-0403-4. Epub 2018 Jan 26.
[Article in German]

Abstract

Background: Survival rate after out-of-hospital cardiac arrest (OHCA) is increasing. However, there is a lack of data concerning long-term quality of life of affected patients.

Objectives: This study aims to investigate the psychological effects of out-of-hospital cardiopulmonary resuscitation.

Methods: All patients who were admitted to our hospital after OHCA between 01 January 2008 and 30 June 2015 and could be discharged in good neurological condition were asked to fill out the Impact of Event Scale-Revised (IES-R) and 36-Item Short Form Health Survey (SF-36). For statistical analysis, the mean, standard deviation and student's t‑test were used (level of significance p < 0.05).

Results: Of 280 OHCA survivors, 56 patients (20.0%) were discharged from the hospital in good neurological condition. Of those, 20 patients (35.7%) were willing to participate in this study, among them 11 women and 9 men. Compared to the cohort of the German normative data, the results of the SF-36 questionnaire of OHCA survivors showed significantly lower values in all SF-36 subscales and also for the summary scores. There was no significant difference compared to patients with myocardial infarction. Average values of the IES-R subscales for intrusion and avoidance were 9.9 ± 9.3 and 9.7 ± 7.7, respectively, and 11.3 ± 7.4 for hyperarousal. Calculations indicated the suspected diagnosis of posttraumatic stress disorder in 2 of the 20 patients (10%).

Discussion: Even in patients who could be discharged from the hospital after OHCA in good neurological condition, the quality of life is significantly lower compared to the standard population but not compared to patients with myocardial infarction. The data also suggest that a relevant number of patients after OHCA is affected by posttraumatic stress disorder. Further research efforts on optimization of post-resuscitation care should not only focus on survival rates but also on improving quality of life.

Keywords: Out-of-hospital cardiac arrest; Out-of-hospital resuscitation; Post-resuscitation care; Posttraumatic stress disorder; Quality of life.

MeSH terms

  • Aged
  • Cardiopulmonary Resuscitation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Out-of-Hospital Cardiac Arrest* / psychology
  • Quality of Life
  • Stress Disorders, Post-Traumatic*
  • Survivors
  • Treatment Outcome