Published online before print October 6, 2003, doi: 10.1161/01.CIR.0000095028.95929.B0
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(Circulation. 2003;108:1939.)
© 2003 American Heart Association, Inc.
Clinical Investigation and Reports |
Health-Related Quality of Life Is Better for Cardiac Arrest Survivors Who Received Citizen Cardiopulmonary Resuscitation
From the Departments of Emergency Medicine (I.S.), Medicine (G.N.), and Epidemiology and Community Medicine (G.W.), Clinical Epidemiology Program (V.D.M., L.N., J.B.), Ottawa Health Research Institute, University of Ottawa, Canada, and Arizona Emergency Medicine Research Center, University of Arizona, Tucson, Ariz (D.S.).
Correspondence to Dr Ian G. Stiell, Clinical Epidemiology Unit, Office F657, Ottawa Health Research Institute, 1053 Carling Ave, Ottawa, Ontario K1Y 4E9, Canada. E-mail istiell{at}ohri.ca
Received January 31, 2002; de novo received May 9, 2003; revision received July 24, 2003; accepted July 26, 2003.
Background— This study evaluated the prehospital factors associated with better health-related quality of life for survivors of out-of-hospital cardiac arrest.
Methods and Results— This prospective, 20-community, cohort study involved consecutive, adult out-of-hospital cardiac arrest patients who survived to 1 year. Patients were contacted by telephone and evaluated for the Health Utilities Index Mark III (HUI3), which describes health as a utility score on a scale from 0 (dead) to 1.0 (perfect health). The 8091 cardiac arrest patients had overall survival rates of 5.2% to hospital discharge and 4.0% to 1 year. We successfully contacted and evaluated 268 of 316 (84.8%) of known 1-year survivors. The median HUI3 score was 0.80 (interquartile range, 0.50 to 0.97), which compares well with age-adjusted values for the general population (0.83). Logistic regression identified 2 factors independently associated with very good quality of life (HUI3 >0.90) and their odds ratios (95% CIs), as follows: age 80 years or older, 0.3 (0.1 to 0.84), and citizen-initiated cardiopulmonary resuscitation (CPR), 2.0 (1.2 to 3.4) (Hosmer-Lemeshow goodness-of-fit statistic, 0.74).
Conclusions— This study is the largest ever conducted for out-of-hospital cardiac arrest survivors, clearly shows that these patients have good quality of life, and is the first to demonstrate that citizen-initiated CPR is strongly and independently associated with better quality of life. These results emphasize the importance of optimizing community citizen CPR readiness. Given the low rate of citizen-initiated CPR in many communities, we believe that local and national initiatives should vigorously promote the practice of bystander CPR.
Key Words: heart arrest • survival • cardiopulmonary resuscitation
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