Systematic review of quality of life and other patient-centred outcomes after cardiac arrest survival

Elliott, Vanessa J.; Rodgers, David L.; Brett, Stephen

doi:10.1016/j.resuscitation.2010.10.030

Cited by 140 publications

(118 citation statements)

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“…These findings extend the HRQoL literature with more detailed psychological assessments, and generally support their assertion that OHCA survivors experience a relatively good quality of life post-OHCA. 9,19 However, the study observed an elevated mean anxiety score for OHCA survivors. This is in keeping with the review by Wilder Schaaf and colleagues, 11 and qualitative research, which demonstrate a particularly high prevalence of anxiety compared with depression.…”

Section: Discussionmentioning

confidence: 69%

“…Other authors have highlighted that QoL research on patients who recover poorly from OHCA is scarce. 9 It is crucial that these patients become adequately represented in the literature, particularly when considering the relationship between psychological wellbeing and neurocognitive function.…”

Section: Discussionmentioning

confidence: 99%

“…8 Resuscitation research is beginning to adopt this multifaceted definition of survival outcomes with HRQoL assessments in OHCA. 9 However, current measures are weighted towards physical functioning, 10 and often fail to evaluate emotional distress. Indeed, Elliott and colleagues state that despite what was reportedly a good HRQoL, "a substantial burden of morbidity exists in the survivor population".…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, Elliott and colleagues state that despite what was reportedly a good HRQoL, "a substantial burden of morbidity exists in the survivor population". 9 The psychological aftermath of OHCA has not been adequately researched. A recent review stated that research is hindered by a lack of methodological consensus, yet the prevalence of depression and anxiety in cardiac arrest survivors could be as high as 45% and 61% respectively.…”

Section: Introductionmentioning

confidence: 99%

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Psychological wellbeing in survivors of cardiac arrest, and its relationship to neurocognitive function

et al. 2017

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Psychological wellbeing in survivors of cardiac arrest, and its relationship to neurocognitive function

et al. 2017

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“…25 Survivors may experience post-arrest problems, including anxiety, depression, post-traumatic stress and difficulties with cognitive function. 26 Despite the annual death toll exceeding that of dementia, stroke or lung cancer, there has been relatively little investment in research into this lethal condition. This has created a relatively weak evidence base compared with other diseases (e.g.…”

Section: Incidence and Burden Of Diseasementioning

confidence: 99%

Prehospital randomised assessment of a mechanical compression device in out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised trial and economic evaluation

Gates

Lall

Quinn

et al. 2017

Health Technol Assess

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BackgroundMechanical chest compression devices may help to maintain high-quality cardiopulmonary resuscitation (CPR), but little evidence exists for their effectiveness. We evaluated whether or not the introduction of Lund University Cardiopulmonary Assistance System-2 (LUCAS-2; Jolife AB, Lund, Sweden) mechanical CPR into front-line emergency response vehicles would improve survival from out-of-hospital cardiac arrest (OHCA).ObjectiveEvaluation of the LUCAS-2 device as a routine ambulance service treatment for OHCA.DesignPragmatic, cluster randomised trial including adults with non-traumatic OHCA. Ambulance dispatch staff and those collecting the primary outcome were blind to treatment allocation. Blinding of the ambulance staff who delivered the interventions and reported initial response to treatment was not possible. We also conducted a health economic evaluation and a systematic review of all trials of out-of-hospital mechanical chest compression.SettingFour UK ambulance services (West Midlands, North East England, Wales and South Central), comprising 91 urban and semiurban ambulance stations. Clusters were ambulance service vehicles, which were randomly assigned (approximately 1 : 2) to the LUCAS-2 device or manual CPR.ParticipantsPatients were included if they were in cardiac arrest in the out-of-hospital environment. Exclusions were patients with cardiac arrest as a result of trauma, with known or clinically apparent pregnancy, or aged < 18 years.InterventionsPatients received LUCAS-2 mechanical chest compression or manual chest compressions according to the first trial vehicle to arrive on scene.Main outcome measuresSurvival at 30 days following cardiac arrest; survival without significant neurological impairment [Cerebral Performance Category (CPC) score of 1 or 2].ResultsWe enrolled 4471 eligible patients (1652 assigned to the LUCAS-2 device and 2819 assigned to control) between 15 April 2010 and 10 June 2013. A total of 985 (60%) patients in the LUCAS-2 group received mechanical chest compression and 11 (< 1%) patients in the control group received LUCAS-2. In the intention-to-treat analysis, 30-day survival was similar in the LUCAS-2 (104/1652, 6.3%) and manual CPR groups [193/2819, 6.8%; adjusted odds ratio (OR) 0.86, 95% confidence interval (CI) 0.64 to 1.15]. Survival with a CPC score of 1 or 2 may have been worse in the LUCAS-2 group (adjusted OR 0.72, 95% CI 0.52 to 0.99). No serious adverse events were noted. The systematic review found no evidence of a survival advantage if mechanical chest compression was used. The health economic analysis showed that LUCAS-2 was dominated by manual chest compression.LimitationsThere was substantial non-compliance in the LUCAS-2 arm. For 272 out of 1652 patients (16.5%), mechanical chest compression was not used for reasons that would not occur in clinical practice. We addressed this issue by using complier average causal effect analyses. We attempted to measure CPR quality during the resuscitation attempts of trial participants, but were unable to do so.ConclusionsThere was no evidence of improvement in 30-day survival with LUCAS-2 compared with manual compressions. Our systematic review of recent randomised trials did not suggest that survival or survival without significant disability may be improved by the use of mechanical chest compression.Future workThe use of mechanical chest compression for in-hospital cardiac arrest, and in specific circumstances (e.g. transport), has not yet been evaluated.TriaI registrationCurrent Controlled Trials ISRCTN08233942.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 21, No. 11. See the NIHR Journals Library website for further project information.

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Systematic review of quality of life and other patient-centred outcomes after cardiac arrest survival

Cited by 140 publications

References 90 publications

Psychological wellbeing in survivors of cardiac arrest, and its relationship to neurocognitive function

Psychological wellbeing in survivors of cardiac arrest, and its relationship to neurocognitive function

Prehospital randomised assessment of a mechanical compression device in out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised trial and economic evaluation

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