Abstract P166: A Review of Duration of Survival and Quality of Life After Cardiopulmonary Resuscitation
Cardiopulmonary resuscitation (CPR) became an area of research and interest following the 1960 landmark article by Kouwenhowen. Subsequent years witnessed the development of governing councils, clinical guidelines, reporting criteria and advances in technology used to reverse clinical death. Despite these changes, survival has minimally improved. A literature search for articles addressing quality of life, duration of survival or neurological status of survivors identified fifty-three articles. The articles demonstrate inconsistent tracking of survivors following discharge. At one month, 455 people are reported alive by 14 reports, 295 are reported alive at three months by 12 studies and, after six months 1,171 survivors among 22 studies are reported. Inconsistent reporting of discharge status prohibits the meta-analytic calculation of survival rates. Forty-one studies (77%) track survivors for one month or longer, while 15 (28%) report three or more time intervals. Ten studies (19%) do not report or do not track survivors. Regarding quality of life, 15 studies (28%) do not discuss neurological status. Twenty-three studies (43%) describe the survivors only as “intact” or “impaired” while three studies describe them as “impaired” or “unconscious”. Information about the effects of the anoxic insult is absent in over 86% of the studies, making it impossible to determine changes in functional status. Clinical exams or interviews with family are the most common method to follow-up functional status. Thus, despite a majority of the studies including this information the literature remains incomplete; further studies are needed to address the identified limitations. The review illustrates that the effect of CPR on survival duration and quality of life remains uncertain. Survivors are present at every time interval, even past 10 years. Evidence of the severe decline in cognitive or functional status frequently seen in pre-hospital studies is not found.