Survivors of out-of-hospital cardiac arrest reported high quality of life across all ages, with high anxiety risk greater in those <35 years compared to >65 years (9.7% vs 2%, p<0.001).
Observational (n=2,552)
Yes
Does age impact the long-term health-related quality of life and psychological burden in survivors of out-of-hospital cardiac arrest?
Survivors of out-of-hospital cardiac arrest report high long-term quality of life across all age groups, though younger survivors experience significantly higher rates of anxiety.
Abstract Background Out-of-hospital cardiac arrest (OHCA) survival has improved leading to a growing population of survivors facing a complex recovery process. Thus, quality of life (QoL) post-arrest is an increasingly important factor. OHCA affects a broad spectrum of individuals, from young athletes with congenital heart disease to multimorbid, frail older individuals. With different stages in life comes different experience, focus and perspectives, why age should be considered when evaluating QoL outcomes in OHCA survivors. Purpose To assess health-related QoL over 20 years following OHCA, across different age groups. Methods In a nationwide survey of patient related outcome measures, EuroQol Health Questionnaire (EQ-5D), 12-Item Short Form Health Survey (SF-12), and Hospital Anxiety and Depression Scale (HADS) were used to assess the physical and mental health-related QoL in survivors of OHCA. All 30-day survivors of OHCA recorded in the Danish Cardiac Arrest Registry between June 1, 2001, and August 31, 2019, who were alive by October 2020 were invited to participate. Patients were stratified into age groups for analysis. Results Among 4545 survivors of OHCA, 2552 (56.1%) completed the survey, including 849 responders aged 65 years. Median age at follow-up was 67 years. The older groups of responders generally had a higher proportion of comorbidities (p0.001). Median EQ-Visual Analog Scale (EQ-VAS) was 78 score for responders 35 years and 75 for responders aged 75 years. The mean EQ-VAS in a Danish reference population was 82 (1), while the median EQ-VAS for the total study population was 80. In the different domains of the EQ-5D, mobility problems were reported by 56.7% of OHCA survivors aged 75 years. Notably, in a Danish reference population, the frequency for mobility problems 70 years of age is 41.4% for women and 38.0% for men (1). The median (IQR) SF-12 physical health score for all responders was 51.2 (40.6-57.6), with a standardized score of 50 being considered normal, using an age- and sex-matched population. In the oldest age group, the median was 44.6 (34.6-52.0), which is still above the threshold set as minus 1 SD of a Danish reference population. There were minimal variations in the other age groups. High risk of depression did not differ by age (Figure 1). Interestingly, high anxiety risk differed markedly with age: 9.7% in responders aged 35 years, 2% in responders aged 65 years (p0.001) (Figure 2). Conclusion Survivors of OHCA in Denmark reported a high QoL across all age groups, comparable to that of the general population. While depression risks were similar with age, anxiety scores declined five-fold with increasing age. These findings suggest that surviving OHCA in old age may be perceived as an extension to life, whereas survival in young age may lead to greater psychological burden. Our results support the notion that resuscitation remains worthwhile, even in older patients.
Gunmalm et al. (Sat,) conducted a observational in Out-of-hospital cardiac arrest (n=2,552). Survivors of out-of-hospital cardiac arrest reported high quality of life across all ages, with high anxiety risk greater in those <35 years compared to >65 years (9.7% vs 2%, p<0.001).