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Tytuł:
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Long-Term Disabilities of Survivors of Out-of-Hospital Cardiac Arrest: The Hanox Study.
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Autorzy:
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Peskine A; Service de Médecine Physique et Réadaptation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.
Cariou A; Service de Médecine Intensive Réanimation, Hôpital Cochin, APHP, Paris et Université de Paris, Faculté de Médecine, Paris, France.
Hajage D; Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, APHP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Département Biostatistique Santé Publique et Information Médicale, Centre de Pharmacoépidémiologie (Cephepi), Paris, France.
Deye N; Service de Médecine Intensive Réanimation, Hôpital Lariboisière, APHP, Paris, France.
Guérot E; Service de Médecine Intensive Réanimation, Hôpital Européen Georges-Pompidou, APHP, Paris, France.
Dres M; Service de Pneumologie et Médecine Intensive Réanimation (département R3S), Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Sonneville R; Service de Médecine Intensive Réanimation, Hôpital Bichat-Claude-Bernard, APHP, Paris, France.
Lafourcade A; Sorbonne Université, INSERM, Institut Pierre-Louis d'Epidémiologie et de Santé Publique, APHP, Hôpitaux Universitaires Pitié-Salpêtrière-Charles Foix, Département Biostatistique Santé Publique et Information Médicale, Centre de Pharmacoépidémiologie (Cephepi), Paris, France.
Navarro V; Sorbonne Université, ICM (Institut du Cerveau et de la Moelle Epinière), INSERM, CNRS, and Unité d'Épilepsie et d'EEG, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
Robert H; Service de Médecine Physique et Réadaptation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.
Azouvi P; Service de Médecine Physique et Réadaptation, Hôpital Raymond-Poincaré, APHP, Garches, France.
Sharshar T; Service de Réanimation Neurochirurgicale, Hôpital Sainte-Anne, Paris, France.
Bayen E; Service de Médecine Physique et Réadaptation, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France.
Luyt CE; Sorbonne Université, INSERM, UMRS_1166-ICAN Institute of Cardiometabolism and Nutrition, and Service de Médecine Intensive Réanimation, Institut de Cardiologie, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France. Electronic address: .
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Corporate Authors:
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Hanox Study Group
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Źródło:
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Chest [Chest] 2021 Feb; Vol. 159 (2), pp. 699-711. Date of Electronic Publication: 2020 Jul 20.
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Typ publikacji:
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Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: 2016- : New York : Elsevier
Original Publication: Chicago : American College of Chest Physicians
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MeSH Terms:
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Glasgow Outcome Scale*
Disabled Persons/*statistics & numerical data
Out-of-Hospital Cardiac Arrest/*complications
Out-of-Hospital Cardiac Arrest/*therapy
Survivors/*statistics & numerical data
Aged ; Female ; Glasgow Coma Scale ; Humans ; Male ; Middle Aged ; Paris ; Risk Factors
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Contributed Indexing:
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Investigator: G Hékimian; N Bréchot; M Schmidt; A Combes; CE Luyt; A Demoule; M Dres; J Mayaux; A Peskine; H Robert; P Pradat-Diehl; E Bayen; V Navarro; D Galanaud; N Marin; J Charpentier; A Cariou; JP Mira; O Vignaud; E Guérot; JL Diehl; JY Fagon; N Deye; B Mégarbane; JP Guichard; N Kubis; A Yelnik; R Sonneville; L Bouadma; JF Timsit; I Klein; T Sharshar; P Azouvi; R Carlier; F Colle
Keywords: cardiac arrest; disability; prognosis
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Molecular Sequence:
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ClinicalTrials.gov NCT02292147
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Entry Date(s):
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Date Created: 20200724 Date Completed: 20210913 Latest Revision: 20230507
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Update Code:
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20240104
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DOI:
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10.1016/j.chest.2020.07.022
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PMID:
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32702410
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Background: Long-term outcomes of awakened survivors of out-of-hospital cardiac arrest (OHCA) are poorly known.
Research Question: What are the month (M) 18 outcomes of survivors of out-of-hospital cardiac arrest (OHCA) who awakened during the first 2 weeks' post-OHCA and their poor-outcome risk factors?
Study Design and Methods: All OHCA survivors with a Glasgow Coma Scale score ≥12 during the first 2 weeks' post-OHCA were enrolled in six ICUs and followed up at M3, M6, M12, and M18. The primary outcome measure was Glasgow Outcome Scale-Extended (GOS-E) score at M18. Secondary outcome measures included evaluation at M18 of neurologic, behavioral, and cognitive disabilities; health-related quality of life (HR-QOL), anxiety and depression; and poor-outcome risk factors (GOS-E score ≤ 6).
Results: Among the 139 included patients, 98 were assessable for the primary outcome measure. At M18, 64 (65%) had full recovery or minor disabilities (GOS-E score > 6), 18 (18%) had moderate disabilities but were autonomous for daily-life activities (GOS-E score = 6), 12 (12%) had poor autonomy (GOS-E score < 6 but > 1), and four had died. Percentages of patients with GOS-E scores > 6 increased significantly over the 18-month study period. At M18, no patients had major neurologic disabilities, 20% had cognitive disabilities, 32% had anxiety symptoms, 25% had depression symptoms, and their HR-QOL was impaired compared with a sex- and age-matched population. Low-flow time, Sequential Organ Failure Assessment score at admission, coma duration > 3 days after cardiac arrest, and mechanical ventilation on days 3 and 7 were associated with poor functional outcome.
Interpretation: Among patients who awoke (Glasgow Coma Scale score ≥12) in the 14 days following OHCA, 35% had moderate to severe disabilities or had died at M18. Interestingly, patients improved until M18 post-OHCA. Risk factors associated with poor functional outcome were low-flow time, clinical severity at ICU admission, prolonged coma duration, and mechanical ventilation.
Clinical Trial Registration: ClinicalTrials.gov; No.: NCT02292147; URL: www.clinicaltrials.gov.
(Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.)
Comment in: Chest. 2021 Mar;159(3):1302-1303. (PMID: 33678257)
Comment in: Chest. 2021 Mar;159(3):1303-1304. (PMID: 33678258)
