Early neurologically-focused follow-up after cardiac arrest improves quality of life at one year: A randomised controlled trial

https://doi.org/10.1016/j.ijcard.2015.04.229Get rights and content
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Abstract

Background

Survivors of a cardiac arrest frequently have cognitive and emotional problems and their quality of life is at risk. We developed a brief nursing intervention to detect cognitive and emotional problems, provide information and support, promote self-management, and refer them to specialised care if necessary. This study examined its effectiveness.

Methods

Multicentre randomised controlled trial with measurements at two weeks, three months and twelve months after cardiac arrest. 185 adult cardiac arrest survivors and 155 caregivers participated. Primary outcome measures were societal participation and quality of life of the survivors at one year. Secondary outcomes were the patient's cognitive functioning, emotional state, extended daily activities and return to work, and the caregiver's well-being. Data were analysed using ‘intention to treat’ linear mixed model analyses.

Results

After one year, patients in the intervention group had a significantly better quality of life on SF-36 domains Role Emotional (estimated mean differences (EMD) = 16.38, p = 0.006), Mental Health (EMD = 6.87, p = 0.003) and General Health (EMD = 8.07, p = 0.010), but there was no significant difference with regard to societal participation. On the secondary outcome measures, survivors scored significantly better on overall emotional state (HADS total, EMD =  3.25, p = 0.002) and anxiety (HADS anxiety, EMD =  1.79, p = 0.001) at one year. Furthermore, at three months more people were back at work (50% versus 21%, p = 0.006). No significant differences were found for caregiver outcomes.

Conclusion

The outcomes of cardiac arrest survivors can be improved by an intervention focused on detecting and managing the cognitive and emotional consequences of a cardiac arrest.

Trial registration

Current controlled trials, ISRCTN74835019.

Keywords

Cardiac arrest
Resuscitation
Cognitive impairments
Psychosocial intervention
Rehabilitation
Quality of life

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All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.