Abstract
Introduction Comorbid conditions have been associated with morbidity, functional status and quality of life for patients with a wide range of diseases. Previous studies have attempted to elucidate the influence of pre-arrest comorbidities on survival and neurological recovery following out-of-hospital cardiac arrest (OHCA), however the findings are conflicting. Methods Baseline comorbidities recorded within prehospital patient care records were linked with baseline and 12-month follow-up data from the Victorian Ambulance Cardiac Arrest Registry for adult (≥16 years) non-traumatic OHCA patients. Dates of death from the Victorian death registry were also obtained for patients surviving to hospital discharge. Multivariable logistic, linear and Cox proportional hazards regression models were used to assess the influence of the Charlson Comorbidity Index (CCI) on survival to hospital discharge, 12-month functional recovery and health-related quality of life (HR-QOL), and long-term mortality over an eight-year period. Results A total of 15,953 patients were included. Increasing CCI was independently associated with reduced odds of survival to hospital discharge (CCI = 1: OR = 0.87 [95% CI 0.76-1.00]; CCI = 2: OR = 0.80 [95% CI 0.68-0.94]; CCI = 3: OR = 0.62 [95% CI 0.50-0.78]; CCI ≥ 4: OR = 0.53 [95% CI 0.41-0.68]). Additionally, increasing CCI was associated with reduced odds of 12-month functional recovery, a reduced chance of favourable 12-month HR-QOL, and an increased hazard of mortality after discharge from hospital. Conclusion Consideration of a patient's baseline comorbidity may assist prognostication decisions for cardiac arrest patients. Exploration of the effect of additional rehabilitation on HR-QOL and long-term survival outcomes for OHCA patients with a high baseline comorbidity burden may be warranted.
| Original language | English |
|---|---|
| Pages (from-to) | 42-47 |
| Number of pages | 6 |
| Journal | Resuscitation |
| Volume | 110 |
| DOIs | |
| Publication status | Published - 1 Jan 2017 |
Keywords
- Comorbidity
- Functional recovery
- Health-related quality of life
- Out-of-hospital cardiac arrest
- Survival
Cite this
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The influence of comorbidity on survival and long-term outcomes after out-of-hospital cardiac arrest. / Andrew, Emily; Nehme, Ziad; Bernard, Stephen; Smith, Karen.
In: Resuscitation, Vol. 110, 01.01.2017, p. 42-47.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - The influence of comorbidity on survival and long-term outcomes after out-of-hospital cardiac arrest
AU - Andrew, Emily
AU - Nehme, Ziad
AU - Bernard, Stephen
AU - Smith, Karen
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Introduction Comorbid conditions have been associated with morbidity, functional status and quality of life for patients with a wide range of diseases. Previous studies have attempted to elucidate the influence of pre-arrest comorbidities on survival and neurological recovery following out-of-hospital cardiac arrest (OHCA), however the findings are conflicting. Methods Baseline comorbidities recorded within prehospital patient care records were linked with baseline and 12-month follow-up data from the Victorian Ambulance Cardiac Arrest Registry for adult (≥16 years) non-traumatic OHCA patients. Dates of death from the Victorian death registry were also obtained for patients surviving to hospital discharge. Multivariable logistic, linear and Cox proportional hazards regression models were used to assess the influence of the Charlson Comorbidity Index (CCI) on survival to hospital discharge, 12-month functional recovery and health-related quality of life (HR-QOL), and long-term mortality over an eight-year period. Results A total of 15,953 patients were included. Increasing CCI was independently associated with reduced odds of survival to hospital discharge (CCI = 1: OR = 0.87 [95% CI 0.76-1.00]; CCI = 2: OR = 0.80 [95% CI 0.68-0.94]; CCI = 3: OR = 0.62 [95% CI 0.50-0.78]; CCI ≥ 4: OR = 0.53 [95% CI 0.41-0.68]). Additionally, increasing CCI was associated with reduced odds of 12-month functional recovery, a reduced chance of favourable 12-month HR-QOL, and an increased hazard of mortality after discharge from hospital. Conclusion Consideration of a patient's baseline comorbidity may assist prognostication decisions for cardiac arrest patients. Exploration of the effect of additional rehabilitation on HR-QOL and long-term survival outcomes for OHCA patients with a high baseline comorbidity burden may be warranted.
AB - Introduction Comorbid conditions have been associated with morbidity, functional status and quality of life for patients with a wide range of diseases. Previous studies have attempted to elucidate the influence of pre-arrest comorbidities on survival and neurological recovery following out-of-hospital cardiac arrest (OHCA), however the findings are conflicting. Methods Baseline comorbidities recorded within prehospital patient care records were linked with baseline and 12-month follow-up data from the Victorian Ambulance Cardiac Arrest Registry for adult (≥16 years) non-traumatic OHCA patients. Dates of death from the Victorian death registry were also obtained for patients surviving to hospital discharge. Multivariable logistic, linear and Cox proportional hazards regression models were used to assess the influence of the Charlson Comorbidity Index (CCI) on survival to hospital discharge, 12-month functional recovery and health-related quality of life (HR-QOL), and long-term mortality over an eight-year period. Results A total of 15,953 patients were included. Increasing CCI was independently associated with reduced odds of survival to hospital discharge (CCI = 1: OR = 0.87 [95% CI 0.76-1.00]; CCI = 2: OR = 0.80 [95% CI 0.68-0.94]; CCI = 3: OR = 0.62 [95% CI 0.50-0.78]; CCI ≥ 4: OR = 0.53 [95% CI 0.41-0.68]). Additionally, increasing CCI was associated with reduced odds of 12-month functional recovery, a reduced chance of favourable 12-month HR-QOL, and an increased hazard of mortality after discharge from hospital. Conclusion Consideration of a patient's baseline comorbidity may assist prognostication decisions for cardiac arrest patients. Exploration of the effect of additional rehabilitation on HR-QOL and long-term survival outcomes for OHCA patients with a high baseline comorbidity burden may be warranted.
KW - Comorbidity
KW - Functional recovery
KW - Health-related quality of life
KW - Out-of-hospital cardiac arrest
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=84994877327&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2016.10.018
DO - 10.1016/j.resuscitation.2016.10.018
M3 - Article
VL - 110
SP - 42
EP - 47
JO - Resuscitation
JF - Resuscitation
SN - 0300-9572
ER -