Association between cognitive function in out-of-hospital cardiac arrest survivors and caregiver burden among caregivers, based on a nested linear regression analysis (n=249).

Association between cognitive function in out-of-hospital cardiac arrest survivors and caregiver burden among caregivers, based on a nested linear regression analysis (n=249).

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Aims To describe burden and health-related quality of life amongst caregivers of out-of-hospital cardiac arrest survivors and explore the potential association with cognitive function of the survivors. Caregivers of patients with ST-elevation myocardial infarction were used as controls. Methods Data were collected from the cognitive substudy of th...

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... variables with significant association to caregiver burden was mRS, country, and 210 cohabitation status. The adjusted model explained 34% of the total variance of caregiver burden 211 (Table 3). The "Role-Emotional" was especially affected, with scores below the norm (Table 2) (Table 2). ...

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Background Patients resuscitated from cardiac arrest who have severe neurological or functional disability at discharge require high-intensity long-term support. However, few data describe the long-term survival and health-care utilization for these patients. Methods We identified a cohort of cardiac arrest survivors ≥18 years of age, treated at a single center in Western Pennsylvania from January 2010 to December 2019, with a modified Rankin scale (mRS) of 5 at hospital discharge. We recorded demographics, cardiac arrest characteristics, and neurological exam at hospital discharge. We characterized long term survival and mortality through December 31, 2020 through National Death Index query. We described survival time overall and in subgroups using Kaplan-Meier curves. We linked cases with administrative data to determine 30, 90 day, and one-year hospital readmission rate. For subjects unable to follow commands at discharge, we reviewed records from index hospitalization to the present to describe improvement in neurological status and return home. Results We screened 2,687 patients of which 975 survived to discharge. We identified 190 subjects with mRS of 5 at hospital discharge who were sent to non-hospice settings. Of these, 43 (23%) did not follow commands at discharge. One-year mortality was 38% (n=71) with a median survival time of 4.2 years (IQR 0.3-10.9). Duration of survival did not differ based on age, sex, or ability to follow commands at hospital discharge. Within the first year of discharge, 58% (n=111) of subjects had at least one hospitalization with a median length of stay of 8 days [IQR 3-19]. Of subjects who did not follow commands at hospital discharge, 5/43 (11%) followed commands and 9 (21%) were reportedly living at home on subsequent encounters. Conclusions Of survivors treated over a decade at our institution, 20% (n= 190) were discharged from the hospital with severe functional disability. One-year mortality was 38%, and hospital readmissions were frequent. Few patients discharged unable to follow commands regained the ability over the period of observation, but many did return to living at home. These data can help inform decision maker expectations for patient trajectory and life expectancy.