Out-of-hospital cardiac arrest survivors experienced more restricted societal participation and a significantly higher rate of sick leave (OR 4.9) at 6 months compared to matched STEMI controls.
Cohort (n=406)
Sí
Does out-of-hospital cardiac arrest reduce societal participation and return to work compared to ST-segment-elevation myocardial infarction in survivors?
OHCA survivors experience significantly more restricted societal participation and lower return to work at 6 months compared to matched STEMI controls, with cognitive impairment being a major predictor of poor functional recovery.
Odds Ratio: 4.9 (95% CI 1.4–16.8)
Tasa de eventos absoluta: 27% vs 7%
valor p: p=0.01
Background: The aim of this study was to describe out-of-hospital cardiac arrest (OHCA) survivors’ ability to participate in activities of everyday life and society, including return to work. The specific aim was to evaluate potential effects of cognitive impairment. Methods and Results: Two hundred eighty-seven OHCA survivors included in the TTM trial (Target Temperature Management) and 119 matched control patients with ST-segment–elevation myocardial infarction participated in a follow-up 180 days post-event that included assessments of participation, return to work, emotional problems, and cognitive impairment. On the Mayo-Portland Adaptability Inventory-4 Participation Index, OHCA survivors (n=270) reported more restricted participation In everyday life and in society (47% versus 30%; P <0.001) compared with ST-segment–elevation myocardial infarction controls (n=118). Furthermore, 27% (n=36) of pre-event working OHCA survivors (n=135) compared with 7% (n=3) of pre-event working ST-segment–elevation myocardial infarction controls (n=45) were on sick leave (odds ratio, 4.9; 95% confidence interval, 1.4–16.8; P =0.01). Among the OHCA survivors assumed to return to work (n=135), those with cognitive impairment (n=55) were 3× more likely (odds ratio, 3.3; 95% confidence interval, 1.2–9.3; P =0.02) to be on sick leave compared with those without cognitive impairment (n=40; 36%, n=20, versus 15%, n=6). For OHCA survivors, the variables that were found most predictive for a lower participation were depression, restricted mobility, memory impairment, novel problem-solving difficulties, fatigue, and slower processing speed. Conclusions: OHCA survivors reported a more restricted societal participation 6 months post-arrest, and their return to work was lower compared with ST-segment–elevation myocardial infarction controls. Cognitive impairment was significantly associated with lower participation, together with the closely related symptoms of fatigue, depression, and restricted mobility. These predictive variables may be used during follow-up to identify OHCA survivors at risk of a less successful recovery that may benefit from further support and rehabilitation. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01946932.
Lilja et al. (Mon,) conducted a cohort in Out-of-hospital cardiac arrest (n=406). Out-of-hospital cardiac arrest vs. ST-segment-elevation myocardial infarction without cardiac arrest was evaluated on Sick leave at 180 days among pre-event working patients (OR 4.9, 95% CI 1.4-16.8, p=0.01). Out-of-hospital cardiac arrest survivors experienced more restricted societal participation and a significantly higher rate of sick leave (OR 4.9) at 6 months compared to matched STEMI controls.