Physical, psychological, cognitive, social health outcomes, and health-related quality of life in out-of-hospital cardiac arrest survivors and their caregivers: Protocol of the quality cardiac arrest survivorship cohort study (QualiCAS)

Abstract

Background

Out-of-hospital cardiac arrest (OHCA) is an emergency with historically low survival rates. Advances in resuscitation and post-resuscitation care have improved survival, precipitating greater scientific interest in OHCA patients’ survivorship. However, there is insufficient high-quality population-based long-term survivorship data and limited research on the impact of OHCA sequelae on survivors’ caregivers.

Objective

Our primary aim is to determine neurological function, physical, psychological, cognitive, social outcomes, and health-related quality of life (HRQoL) of OHCA survivors in Singapore. Secondary aims are to quantify caregivers’ burden and its association with their HRQoL, and psychological well-being.

Methods

The Quality Cardiac Arrest Survivorship Cohort Study (QualiCAS) is a prospective population-based cohort study of OHCA survivors and their caregivers in Singapore. Participants aged ≥18 years and caregivers aged ≥21 years will be recruited from all public hospitals in Singapore. Health outcomes will be evaluated at 3, 6, and 12 months, and 3 and 5 years using the Hospital Anxiety and Depression Scale, PTSD Checklist for DSM-5, Fatigue Severity Scale, Montreal Cognitive Assessment Tool, EQ-5D-5L, Community Integration Questionnaire-Revised, Barthel Index, Lawton’s Instrumental Activities of Daily Living, Timed Up and Go Test, Handgrip strength assessment, and Zarit Burden Interview.

Discussion

This study allows us to understand the natural history of OHCA survivorship and quantify the burdens on patients and their caregivers. Findings can guide clinical follow-up, identify high-risk patients, intervention targets, and inform rehabilitation strategies for OHCA sequelae.