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Long-term survival, functional capacity and quality of life after refractory out-of-hospital cardiac arrest treated with mechanical circulatory support. 使用机械循环支持治疗难治性院外心脏骤停后的长期存活率、功能能力和生活质量。
Pub Date : 2023-06-01 DOI: 10.2139/ssrn.4341090
S. Rasalingam Mørk, Lola Qvist Kristensen, S. Christensen, M. Tang, C. Juhl Terkelsen, H. Eiskjær
Introduction Studies on long-term outcomes after refractory out-of-hospital cardiac arrest (OHCA) treated with mechanical circulatory support (MCS) are limited. This study aimed to evaluate long-term neurologically intact survival, functional capacity and quality of life after refractory OHCA treated with MCS. Methods This was a follow-up study of survivors after refractory OHCA treated with MCS. Follow-up examinations comprised clinical assessment with transthoracic echocardiography and cardiopulmonary exercise test (CPX). Neurological and cognitive screening was evaluated with the Cerebral Performance Category (CPC) and Montreal Cognitive Assessment (MoCA test). A good neurological outcome was defined as CPC 1 or CPC 2. Health-related quality of life was measured by questionnaires (Short Form-36 (SF-36)). Results A total of 101 patients with refractory OHCA were treated with MCS at Aarhus University Hospital between 2015 and 2019. The total low-flow time was median 105 min [IQR, 94-123] minutes. The hospital discharge rate was 27%. At a mean follow-up time of 4.8 years ± 1.6 (range 2.8-6.1 years), 21 patients remained alive of whom 15 consented to participate in the present study. Good neurological outcome with CPC 1-2 was found in 93% (14/15) patients. No severe cognitive function was discovered; mean MoCA score of 26.4 ± 3.1. Functional capacity examined by CPX showed acceptable VO2 max values (23.9 ± 6.3 mL/kg/min). Mean SF-36 scores revealed an overall high level of quality of life in long-term survivors. Conclusions Long-term survival with a good neurological outcome with functional recovery was high in patients with refractory OHCA treated with MCS. These patients may expect a reasonable quality of life after discharge despite prolonged resuscitation.
导言:有关难治性院外心脏骤停(OHCA)患者接受机械循环支持(MCS)治疗后的长期预后的研究非常有限。本研究旨在评估使用机械循环支持治疗难治性院外心脏骤停后的长期神经功能完好存活率、功能能力和生活质量。 方法 这是一项对接受 MCS 治疗的难治性 OHCA 幸存者进行的随访研究。随访检查包括临床评估、经胸超声心动图和心肺运动测试(CPX)。通过脑功能分类(CPC)和蒙特利尔认知评估(MoCA 测试)对神经和认知筛查进行评估。良好的神经功能结果被定义为 CPC 1 或 CPC 2。健康相关生活质量通过问卷调查(SF-36 短表)进行测量。 结果 2015年至2019年期间,奥胡斯大学医院共对101名难治性OHCA患者进行了MCS治疗。低流量总时间中位数为 105 分钟 [IQR, 94-123] 分钟。出院率为 27%。平均随访时间为 4.8 年 ± 1.6(范围为 2.8-6.1 年),21 名患者仍然存活,其中 15 人同意参与本研究。93%(14/15)的患者神经功能状况良好,CPC 为 1-2。没有发现严重的认知功能障碍;平均 MoCA 得分为 26.4 ± 3.1。通过 CPX 进行的功能能力检查显示,最大 VO2 值(23.9 ± 6.3 mL/kg/min)尚可接受。平均 SF-36 评分显示,长期存活者的总体生活质量较高。 结论 在接受 MCS 治疗的难治性 OHCA 患者中,神经功能恢复良好的长期存活率较高。尽管抢救时间较长,但这些患者出院后仍有望获得合理的生活质量。
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Resuscitation Plus
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