Post-intensive care syndrome and health-related quality of life in long-term survivors of cardiac arrest: a prospective cohort study.
Cardiopulmonary resuscitation
Long-term outcomes
Post-intensive care syndrome
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
08 May 2024
08 May 2024
Historique:
received:
01
11
2023
accepted:
02
05
2024
medline:
9
5
2024
pubmed:
9
5
2024
entrez:
8
5
2024
Statut:
epublish
Résumé
Patients discharged from intensive care are at risk for post-intensive care syndrome (PICS), which consists of physical, psychological, and/or neurological impairments. This study aimed to analyze PICS at 24 months follow-up, to identify potential risk factors for PICS, and to assess health-related quality of life in a long-term cohort of adult cardiac arrest survivors. This prospective cohort study included adult cardiac arrest survivors admitted to the intensive care unit of a Swiss tertiary academic medical center. The primary endpoint was the prevalence of PICS at 24 months follow-up, defined as impairments in physical (measured through the European Quality of Life 5-Dimensions-3-Levels instrument [EQ-5D-3L]), neurological (defined as Cerebral Performance Category Score > 2 or Modified Rankin Score > 3), and psychological (based on the Hospital Anxiety and Depression Scale and the Impact of Event Scale-Revised) domains. Among 107 cardiac arrest survivors that completed the 2-year follow-up, 46 patients (43.0%) had symptoms of PICS, with 41 patients (38.7%) experiencing symptoms in the physical domain, 16 patients (15.4%) in the psychological domain, and 3 patients (2.8%) in the neurological domain. Key predictors for PICS in multivariate analyses were female sex (adjusted odds ratio [aOR] 3.17, 95% CI 1.08 to 9.3), duration of no-flow interval during cardiac arrest (minutes) (aOR 1.17, 95% CI 1.02 to 1.33), post-discharge job-loss (aOR 31.25, 95% CI 3.63 to 268.83), need for ongoing psychological support (aOR 3.64, 95% CI 1.29 to 10.29) or psychopharmacologic treatment (aOR 9.49, 95% CI 1.9 to 47.3), and EQ-visual analogue scale (points) (aOR 0.88, 95% CI 0.84 to 0.93). More than one-third of cardiac arrest survivors experience symptoms of PICS 2 years after resuscitation, with the highest impairment observed in the physical and psychological domains. However, long-term survivors of cardiac arrest report intact health-related quality of life when compared to the general population. Future research should focus on appropriate prevention, screening, and treatment strategies for PICS in cardiac arrest patients.
Identifiants
pubmed: 38719863
doi: 10.1038/s41598-024-61146-8
pii: 10.1038/s41598-024-61146-8
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
10533Subventions
Organisme : Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
ID : 320030_169379
Organisme : Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
ID : 10001C_192850/1
Organisme : Swiss Society of General Internal Medicine
ID : 10531C_182422
Informations de copyright
© 2024. The Author(s).
Références
Gräsner, J. T. et al. European resuscitation council guidelines 2021: Epidemiology of cardiac arrest in Europe. Resuscitation. 161, 61–79 (2021).
pubmed: 33773833
doi: 10.1016/j.resuscitation.2021.02.007
Tsao, C. W. et al. Heart disease and stroke statistics-2023 update: A report from the American heart association. Circulation. 147(8), e93–e621 (2023).
pubmed: 36695182
doi: 10.1161/CIR.0000000000001123
Yaow, C. Y. L. et al. Prevalence of anxiety, depression, and post-traumatic stress disorder after cardiac arrest: A systematic review and meta-analysis. Resuscitation. 170, 82–91 (2022).
pubmed: 34826580
doi: 10.1016/j.resuscitation.2021.11.023
Vincent, A. et al. Post-intensive care syndrome in out-of-hospital cardiac arrest patients: A prospective observational cohort study. PLoS ONE. 17(10), e0276011 (2022).
pubmed: 36240252
pmcid: 9565684
doi: 10.1371/journal.pone.0276011
Jerkeman, M. et al. Trends in survival after cardiac arrest: A Swedish nationwide study over 30 years. Eur. Heart J. 43(46), 4817–4829 (2022).
pubmed: 35924401
pmcid: 9726448
doi: 10.1093/eurheartj/ehac414
Herridge, M. S. & Azoulay, É. Outcomes after critical illness. N. Engl. J. Med. 388(10), 913–924 (2023).
pubmed: 36884324
doi: 10.1056/NEJMra2104669
Rousseau, A. F. et al. Long-term outcomes after critical illness: Recent insights. Crit. Care 25(1), 108 (2021).
pubmed: 33731201
pmcid: 7968190
doi: 10.1186/s13054-021-03535-3
Needham, D. M. et al. Improving long-term outcomes after discharge from intensive care unit: Report from a stakeholders’ conference. Crit. Care Med. 40(2), 502–509 (2012).
pubmed: 21946660
doi: 10.1097/CCM.0b013e318232da75
Marra, A. et al. Co-occurrence of post-intensive care syndrome problems among 406 survivors of critical illness. Crit. Care Med. 46(9), 1393–1401 (2018).
pubmed: 29787415
pmcid: 6095801
doi: 10.1097/CCM.0000000000003218
Weidman, K. et al. Post-intensive care unit syndrome in a cohort of COVID-19 survivors in New York City. Ann. Am. Thorac. Soc. 19(7), 1158–1168 (2022).
pubmed: 34936536
pmcid: 9278639
doi: 10.1513/AnnalsATS.202104-520OC
Hatch, R. et al. Anxiety, depression and post traumatic stress disorder after critical illness: A UK-wide prospective cohort study. Crit. Care 22(1), 310 (2018).
pubmed: 30466485
pmcid: 6251214
doi: 10.1186/s13054-018-2223-6
Morgan, A. Long-term outcomes from critical care. Surgery (Oxford). 39(1), 53–57 (2021).
pubmed: 33519011
doi: 10.1016/j.mpsur.2020.11.005
Higa, K. C. et al. Sounding the alarm: What clinicians need to know about physical, emotional and cognitive recovery after venoarterial extracorporeal membrane oxygenation. Crit. Care Med. 51(9), 1234–1245 (2023).
pubmed: 37163480
doi: 10.1097/CCM.0000000000005900
Ramnarain, D., Den Oudsten, B., Oldenbeuving, A., Pouwels, S. & De Vries, J. Post-intensive care syndrome in patients suffering from acute subarachnoid hemorrhage: Results from an outpatient post-ICU aftercare clinic. Cureus. 15(3), e36739 (2023).
pubmed: 37123775
pmcid: 10139679
Bein, T., Weber-Carstens, S. & Apfelbacher, C. Long-term outcome after the acute respiratory distress syndrome: Different from general critical illness?. Curr. Opin. Crit. Care. 24(1), 35–40 (2018).
pubmed: 29189296
pmcid: 5757654
doi: 10.1097/MCC.0000000000000476
Hirshberg, E. L. et al. Impact of critical illness on resource utilization: A comparison of use in the year before and after ICU admission. Crit. Care Med. 47(11), 1497–1504 (2019).
pubmed: 31517693
pmcid: 6798747
doi: 10.1097/CCM.0000000000003970
Cuthbertson, B. H., Roughton, S., Jenkinson, D., Maclennan, G. & Vale, L. Quality of life in the 5 years after intensive care: A cohort study. Crit. Care 14(1), R6 (2010).
pubmed: 20089197
pmcid: 2875518
doi: 10.1186/cc8848
Schwitzer, E. et al. Survival ≠ recovery: A narrative review of post-intensive care syndrome. CHEST Crit. Care. 1(1), 100003 (2023).
doi: 10.1016/j.chstcc.2023.100003
Lee, J. et al. Analysis of anxiety or depression and long-term mortality among survivors of out-of-hospital cardiac arrest. JAMA Netw. Open. 6(4), e237809 (2023).
pubmed: 37043200
pmcid: 10098954
doi: 10.1001/jamanetworkopen.2023.7809
Chin, Y. H. et al. Long-term outcomes after out-of-hospital cardiac arrest: A systematic review and meta-analysis. Resuscitation. 171, 15–29 (2022).
pubmed: 34971720
doi: 10.1016/j.resuscitation.2021.12.026
Viktorisson, A., Sunnerhagen, K. S., Johansson, D., Herlitz, J. & Axelsson, Å. One-year longitudinal study of psychological distress and self-assessed health in survivors of out-of-hospital cardiac arrest. BMJ Open. 9(7), e029756 (2019).
pubmed: 31272987
pmcid: 6615909
doi: 10.1136/bmjopen-2019-029756
Peskine, A. et al. Long-term disabilities of survivors of out-of-hospital cardiac arrest: The hanox study. Chest. 159(2), 699–711 (2021).
pubmed: 32702410
doi: 10.1016/j.chest.2020.07.022
Wilder Schaaf, K. P. et al. Anxiety, depression, and PTSD following cardiac arrest: A systematic review of the literature. Resuscitation. 84(7), 873–877 (2013).
pubmed: 23200996
doi: 10.1016/j.resuscitation.2012.11.021
Steinbusch, C. V. M., van Heugten, C. M., Rasquin, S. M. C., Verbunt, J. A. & Moulaert, V. R. M. Cognitive impairments and subjective cognitive complaints after survival of cardiac arrest: A prospective longitudinal cohort study. Resuscitation. 120, 132–137 (2017).
pubmed: 28818523
doi: 10.1016/j.resuscitation.2017.08.007
Moulaert, V. R., Verbunt, J. A., van Heugten, C. M. & Wade, D. T. Cognitive impairments in survivors of out-of-hospital cardiac arrest: A systematic review. Resuscitation. 80(3), 297–305 (2009).
pubmed: 19117659
doi: 10.1016/j.resuscitation.2008.10.034
Blatter, R. et al. Comparison of different clinical risk scores to predict long-term survival and neurological outcome in adults after cardiac arrest: Results from a prospective cohort study. Ann. Intensive Care. 12(1), 77 (2022).
pubmed: 35978065
pmcid: 9385915
doi: 10.1186/s13613-022-01048-y
Blatter, R. et al. External validation of the PROLOGUE score to predict neurological outcome in adult patients after cardiac arrest: A prospective cohort study. Scand. J. Trauma Resusc. Emerg. Med. 31(1), 16 (2023).
pubmed: 37016393
pmcid: 10074653
doi: 10.1186/s13049-023-01081-1
Boerlin, A. et al. Low plasma sphingomyelin levels show a weak association with poor neurological outcome in cardiac arrest patients: Results from the prospective, observational COMMUNICATE trial. J. Clin. Med. 9(4), 897 (2020).
pubmed: 32218134
pmcid: 7230482
doi: 10.3390/jcm9040897
Herzog, N. et al. Association of taurine with in-hospital mortality in patients after out-of-hospital cardiac arrest: Results from the prospective, observational COMMUNICATE study. J. Clin. Med. 9(5), 1405 (2020).
pubmed: 32397548
pmcid: 7290691
doi: 10.3390/jcm9051405
Hochstrasser, S. R. et al. Trimethylamine-N-oxide (TMAO) predicts short- and long-term mortality and poor neurological outcome in out-of-hospital cardiac arrest patients. Clin. Chem. Lab. Med. 59(2), 393–402 (2020).
pubmed: 32866111
doi: 10.1515/cclm-2020-0159
Isenschmid, C. et al. Routine blood markers from different biological pathways improve early risk stratification in cardiac arrest patients: Results from the prospective, observational COMMUNICATE study. Resuscitation. 130, 138–145 (2018).
pubmed: 30036589
doi: 10.1016/j.resuscitation.2018.07.021
Isenschmid, C. et al. Performance of clinical risk scores to predict mortality and neurological outcome in cardiac arrest patients. Resuscitation. 136, 21–29 (2019).
pubmed: 30391369
doi: 10.1016/j.resuscitation.2018.10.022
Widmer, M. et al. Association of acyl carnitines and mortality in out-of-hospital-cardiac-arrest patients: Results of a prospective observational study. J. Crit. Care. 58, 20–26 (2020).
pubmed: 32279017
doi: 10.1016/j.jcrc.2020.03.009
Nolan, J. P. et al. European resuscitation council and European society of intensive care medicine guidelines 2021: Post-resuscitation care. Intensive Care Med. 47(4), 369–421 (2021).
pubmed: 33765189
pmcid: 7993077
doi: 10.1007/s00134-021-06368-4
Nolan, J. P. et al. European resuscitation council and European society of intensive care medicine guidelines for post-resuscitation care 2015: Section 5. Resuscitation. 95, 202–222 (2015).
pubmed: 26477702
doi: 10.1016/j.resuscitation.2015.07.018
Nolan, J. P. et al. European resuscitation council guidelines for resuscitation 2010 section 1. Resuscitation. 81(10), 1219–1276 (2010).
pubmed: 20956052
doi: 10.1016/j.resuscitation.2010.08.021
von Elm, E. et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. The Lancet. 370(9596), 1453–1457 (2007).
doi: 10.1016/S0140-6736(07)61602-X
Declaration of Helsinki [Available from: https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/ .
Reynolds, J. C. “There’s a hole in my bucket”: “No-flow”, “low-flow”, and resuscitative calculus. Resuscitation. 155, 236–238 (2020).
pubmed: 32755667
doi: 10.1016/j.resuscitation.2020.07.018
Le Gall, J.-R., Lemeshow, S. & Saulnier, F. A new simplified acute physiology score (SAPS II) based on a European/North American multicenter study. Jama. 270(24), 2957–2963 (1993).
pubmed: 8254858
doi: 10.1001/jama.1993.03510240069035
Knaus, W. A., Draper, E. A., Wagner, D. P. & Zimmerman, J. E. APACHE II: a severity of disease classification system. Crit. Care Med. 13(10), 818–829 (1985).
pubmed: 3928249
doi: 10.1097/00003246-198510000-00009
Preiser, J. C., Herridge, M. S. & Azoulay, É. Post-Intensive Care Syndrome 1st edn. (Springer, 2020).
doi: 10.1007/978-3-030-24250-3
Nowels, D., McGloin, J., Westfall, J. M. & Holcomb, S. Validation of the EQ-5D quality of life instrument in patients after myocardial infarction. Qual. Life Res. 14(1), 95–105 (2005).
pubmed: 15789944
doi: 10.1007/s11136-004-0614-4
EQ-5D-3L User Guide [Internet]. EuroQol Research Foundation. 2018. https://euroqol.org/publications/user-guides .
Zigmond, A. S. & Snaith, R. P. The hospital anxiety and depression scale. Acta Psychiatr. Scand. 67(6), 361–370 (1983).
pubmed: 6880820
doi: 10.1111/j.1600-0447.1983.tb09716.x
Bjelland, I., Dahl, A. A., Haug, T. T. & Neckelmann, D. The validity of the hospital anxiety and depression scale. An updated literature review. J. Psychosom. Res. 52(2), 69–77 (2002).
pubmed: 11832252
doi: 10.1016/S0022-3999(01)00296-3
Anderson, D., Lord, C., Risi, S., DiLavore, P., Shulman, C., Thurm, A., et al. (2013). Diagnostic and statistical manual of mental disorders. In The Linguistic and Cognitive Effects of Bilingualism on Children with Autism Spectrum Disorders (Washington, DC: American Psychiatric Association, 2017), vol. 21, p 175.
Maercker, A. & Schützwohl, M. Erfassung von psychischen Belastungsfolgen: Die Impact of Event Skala-revidierte Version (IES-R). [Assessment of post-traumatic stress reactions: The Impact of Event Scale-Revised (IES-R)]. Diagnostica. 44(3), 130–141 (1998).
Grossestreuer, A. V. et al. Inter-rater reliability of post-arrest cerebral performance category (CPC) scores. Resuscitation. 109, 21–24 (2016).
pubmed: 27650863
pmcid: 5990009
doi: 10.1016/j.resuscitation.2016.09.006
Jennett, B. & Bond, M. Assessment of outcome after severe brain damage. The Lancet 1(7905), 480–484 (1975).
doi: 10.1016/S0140-6736(75)92830-5
Perkins, G. D. et al. Cardiac arrest and cardiopulmonary resuscitation outcome reports: update of the Utstein Resuscitation Registry Templates for Out-of-Hospital Cardiac Arrest: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation (American Heart Association, European Resuscitation Council, Australian and New Zealand Council on Resuscitation, Heart and Stroke Foundation of Canada, InterAmerican Heart Foundation, Resuscitation Council of Southern Africa, Resuscitation Council of Asia); and the American Heart Association Emergency Cardiovascular Care Committee and the Council on Cardiopulmonary, Critical Care, Perioperative Resuscitation. Circulation. 132(13), 1286–1300 (2015).
pubmed: 25391522
doi: 10.1161/CIR.0000000000000144
Geocadin, R. G. et al. Standards for studies of neurological prognostication in comatose survivors of cardiac arrest: A scientific statement from the American heart association. Circulation. 140(9), e517–e542 (2019).
pubmed: 31291775
doi: 10.1161/CIR.0000000000000702
Cheng, L. J., Tan, R. L. & Luo, N. Measurement properties of the EQ VAS around the globe: A systematic review and meta-regression analysis. Value Health. 24(8), 1223–1233 (2021).
pubmed: 34372988
doi: 10.1016/j.jval.2021.02.003
Perneger, T. V., Combescure, C. & Courvoisier, D. S. General population reference values for the French version of the EuroQol EQ-5D health utility instrument. Value Health. 13(5), 631–635 (2010).
pubmed: 20412541
doi: 10.1111/j.1524-4733.2010.00727.x
Sterne, J. A. et al. Multiple imputation for missing data in epidemiological and clinical research: Potential and pitfalls. Bmj. 338, b2393 (2009).
pubmed: 19564179
pmcid: 2714692
doi: 10.1136/bmj.b2393
Dinglas, V. D. et al. muscle weakness and 5-year survival in acute respiratory distress syndrome survivors. Crit. Care Med. 45(3), 446–453 (2017).
pubmed: 28067712
pmcid: 5315580
doi: 10.1097/CCM.0000000000002208
Callahan, L. A. & Supinski, G. S. Sepsis-induced myopathy. Crit. Care Med. 37(10 Suppl), S354–S367 (2009).
pubmed: 20046121
pmcid: 3967515
doi: 10.1097/CCM.0b013e3181b6e439
Brown, S. M. et al. Understanding patient outcomes after acute respiratory distress syndrome: Identifying subtypes of physical, cognitive and mental health outcomes. Thorax. 72(12), 1094–1103 (2017).
pubmed: 28778920
doi: 10.1136/thoraxjnl-2017-210337
Geense, W. W. et al. New physical, mental, and cognitive problems 1 year after ICU admission: A prospective multicenter study. Am. J. Respir. Crit. Care Med. 203(12), 1512–1521 (2021).
pubmed: 33526001
doi: 10.1164/rccm.202009-3381OC
Wimmer, H. et al. Health-related quality of life after out-of-hospital cardiac arrest—A 5-year follow-up study. Resuscitation. 162, 372–380 (2021).
pubmed: 33571604
doi: 10.1016/j.resuscitation.2021.01.036
Smith, K., Andrew, E., Lijovic, M., Nehme, Z. & Bernard, S. Quality of life and functional outcomes 12 months after out-of-hospital cardiac arrest. Circulation. 131(2), 174–181 (2015).
pubmed: 25355914
doi: 10.1161/CIRCULATIONAHA.114.011200
Pek, P. P. et al. Determinants of health-related quality of life after out-of-hospital cardiac arrest (OHCA): A systematic review. Resuscitation. 188, 109794 (2023).
pubmed: 37059353
doi: 10.1016/j.resuscitation.2023.109794
Lee, M., Kang, J. & Jeong, Y. J. Risk factors for post–intensive care syndrome: A systematic review and meta-analysis. Aust. Crit. Care. 33(3), 287–294 (2020).
pubmed: 31839375
doi: 10.1016/j.aucc.2019.10.004
Nehme, Z., Andrew, E., Bernard, S. & Smith, K. Sex differences in the quality-of-life and functional outcome of cardiac arrest survivors. Resuscitation. 137, 21–28 (2019).
pubmed: 30735739
doi: 10.1016/j.resuscitation.2019.01.034
Mody, P. et al. Gender-based differences in outcomes among resuscitated patients with out-of-hospital cardiac arrest. Circulation. 143(7), 641–649 (2021).
pubmed: 33317326
doi: 10.1161/CIRCULATIONAHA.120.050427
Todorov, A. et al. Gender differences in the provision of intensive care: A Bayesian approach. Intensive Care Med. 47(5), 577–587 (2021).
pubmed: 33884452
pmcid: 8139895
doi: 10.1007/s00134-021-06393-3
Feng, D., Li, C., Yang, X. & Wang, L. Gender differences and survival after an out-of-hospital cardiac arrest: A systematic review and meta-analysis. Intern. Emerg. Med. 16(3), 765–775 (2021).
pubmed: 33174152
doi: 10.1007/s11739-020-02552-4
Baumann, S. M. et al. Sex-related differences in adult patients with status epilepticus: A seven-year two-center observation. Critical Care. 27(1), 308 (2023).
pubmed: 37543625
pmcid: 10403848
doi: 10.1186/s13054-023-04592-6
Su, H. et al. Interrelationships among workload, illness severity, and function on return to work following acute respiratory distress syndrome. Aust. Crit. Care Off. J. Confed. Aust. Crit. Care Nurses. 36(2), 247–253 (2023).
Sulzgruber, P. et al. Survivors of cardiac arrest with good neurological outcome show considerable impairments of memory functioning. Resuscitation. 88, 120–125 (2015).
pubmed: 25461492
doi: 10.1016/j.resuscitation.2014.11.009
Lilja, G. et al. Cognitive function in survivors of out-of-hospital cardiac arrest after target temperature management at 33°C versus 36°C. Circulation. 131(15), 1340–1349 (2015).
pubmed: 25681466
doi: 10.1161/CIRCULATIONAHA.114.014414
Tiainen, M. et al. Functional outcome, cognition and quality of life after out-of-hospital cardiac arrest and therapeutic hypothermia: Data from a randomized controlled trial. Scand. J. Trauma Resusc. Emerg. Med. 23, 12 (2015).
pubmed: 25652686
pmcid: 4344753
doi: 10.1186/s13049-014-0084-9