Long-Term Disabilities of Survivors of Out-of-Hospital Cardiac Arrest: The Hanox Study
Long-term outcomes of awakened survivors of out-of-hospital cardiac arrest (OHCA) are poorly known. 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? All OHCA survivors w...
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Veröffentlicht in: | Chest 2021-02, Vol.159 (2), p.699-711 |
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creator | Peskine, Anne Cariou, Alain Hajage, David Deye, Nicolas Guérot, Emmanuel Dres, Martin Sonneville, Romain Lafourcade, Alexandre Navarro, Vincent Robert, Hélène Azouvi, Philippe Sharshar, Tarek Bayen, Eleonore Luyt, Charles-Edouard |
description | Long-term outcomes of awakened survivors of out-of-hospital cardiac arrest (OHCA) are poorly known.
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?
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).
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.
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.
ClinicalTrials.gov; No.: NCT02292147; URL: www.clinicaltrials.gov. |
doi_str_mv | 10.1016/j.chest.2020.07.022 |
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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?
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).
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.
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.
ClinicalTrials.gov; No.: NCT02292147; URL: www.clinicaltrials.gov.</description><identifier>EISSN: 1931-3543</identifier><identifier>DOI: 10.1016/j.chest.2020.07.022</identifier><identifier>PMID: 32702410</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Disabled Persons - statistics & numerical data ; Female ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Humans ; Male ; Middle Aged ; Out-of-Hospital Cardiac Arrest - complications ; Out-of-Hospital Cardiac Arrest - therapy ; Paris ; Risk Factors ; Survivors - statistics & numerical data</subject><ispartof>Chest, 2021-02, Vol.159 (2), p.699-711</ispartof><rights>Copyright © 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,27925,27926</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32702410$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peskine, Anne</creatorcontrib><creatorcontrib>Cariou, Alain</creatorcontrib><creatorcontrib>Hajage, David</creatorcontrib><creatorcontrib>Deye, Nicolas</creatorcontrib><creatorcontrib>Guérot, Emmanuel</creatorcontrib><creatorcontrib>Dres, Martin</creatorcontrib><creatorcontrib>Sonneville, Romain</creatorcontrib><creatorcontrib>Lafourcade, Alexandre</creatorcontrib><creatorcontrib>Navarro, Vincent</creatorcontrib><creatorcontrib>Robert, Hélène</creatorcontrib><creatorcontrib>Azouvi, Philippe</creatorcontrib><creatorcontrib>Sharshar, Tarek</creatorcontrib><creatorcontrib>Bayen, Eleonore</creatorcontrib><creatorcontrib>Luyt, Charles-Edouard</creatorcontrib><creatorcontrib>Hanox Study Group</creatorcontrib><title>Long-Term Disabilities of Survivors of Out-of-Hospital Cardiac Arrest: The Hanox Study</title><title>Chest</title><addtitle>Chest</addtitle><description>Long-term outcomes of awakened survivors of out-of-hospital cardiac arrest (OHCA) are poorly known.
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?
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).
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.
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.
ClinicalTrials.gov; No.: NCT02292147; URL: www.clinicaltrials.gov.</description><subject>Aged</subject><subject>Disabled Persons - statistics & numerical data</subject><subject>Female</subject><subject>Glasgow Coma Scale</subject><subject>Glasgow Outcome Scale</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Out-of-Hospital Cardiac Arrest - complications</subject><subject>Out-of-Hospital Cardiac Arrest - therapy</subject><subject>Paris</subject><subject>Risk Factors</subject><subject>Survivors - statistics & numerical data</subject><issn>1931-3543</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kF9LwzAUxYMgbk4_gSB59CU1_9v4NuZ0wmAPm76WrElcRrvUpB3u21t0Pp174Me99xwA7gjOCCbycZ9VO5u6jGKKM5xnmNILMCaKEcQEZyNwndIeY0yIkldgxGiOKSd4DD6W4fCJNjY28NknvfW177xNMDi47uPRH0P8Nau-Q8GhRUit73QNZzoarys4jXG4-wQ3OwsX-hC-4brrzekGXDpdJ3t71gl4f5lvZgu0XL2-zaZL1FJCOiS4krSQ0jkrsGLGWSt5oZgmKi-42BrCCTNWVjl3QguliqowQyhHpcJ8mCbg4W9vG8NXP3xSNj5Vtq71wYY-lZTTnGEx5B7Q-zPabxtryjb6RsdT-d8F-wH1Zl7Q</recordid><startdate>202102</startdate><enddate>202102</enddate><creator>Peskine, Anne</creator><creator>Cariou, Alain</creator><creator>Hajage, David</creator><creator>Deye, Nicolas</creator><creator>Guérot, Emmanuel</creator><creator>Dres, Martin</creator><creator>Sonneville, Romain</creator><creator>Lafourcade, Alexandre</creator><creator>Navarro, Vincent</creator><creator>Robert, Hélène</creator><creator>Azouvi, Philippe</creator><creator>Sharshar, Tarek</creator><creator>Bayen, Eleonore</creator><creator>Luyt, Charles-Edouard</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>202102</creationdate><title>Long-Term Disabilities of Survivors of Out-of-Hospital Cardiac Arrest: The Hanox Study</title><author>Peskine, Anne ; Cariou, Alain ; Hajage, David ; Deye, Nicolas ; Guérot, Emmanuel ; Dres, Martin ; Sonneville, Romain ; Lafourcade, Alexandre ; Navarro, Vincent ; Robert, Hélène ; Azouvi, Philippe ; Sharshar, Tarek ; Bayen, Eleonore ; Luyt, Charles-Edouard</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p211t-54962866ffe5093dfee64893a197845bd1413de6c74f5a5998c8d931f26904d93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Disabled Persons - statistics & numerical data</topic><topic>Female</topic><topic>Glasgow Coma Scale</topic><topic>Glasgow Outcome Scale</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Out-of-Hospital Cardiac Arrest - complications</topic><topic>Out-of-Hospital Cardiac Arrest - therapy</topic><topic>Paris</topic><topic>Risk Factors</topic><topic>Survivors - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peskine, Anne</creatorcontrib><creatorcontrib>Cariou, Alain</creatorcontrib><creatorcontrib>Hajage, David</creatorcontrib><creatorcontrib>Deye, Nicolas</creatorcontrib><creatorcontrib>Guérot, Emmanuel</creatorcontrib><creatorcontrib>Dres, Martin</creatorcontrib><creatorcontrib>Sonneville, Romain</creatorcontrib><creatorcontrib>Lafourcade, Alexandre</creatorcontrib><creatorcontrib>Navarro, Vincent</creatorcontrib><creatorcontrib>Robert, Hélène</creatorcontrib><creatorcontrib>Azouvi, Philippe</creatorcontrib><creatorcontrib>Sharshar, Tarek</creatorcontrib><creatorcontrib>Bayen, Eleonore</creatorcontrib><creatorcontrib>Luyt, Charles-Edouard</creatorcontrib><creatorcontrib>Hanox Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Chest</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peskine, Anne</au><au>Cariou, Alain</au><au>Hajage, David</au><au>Deye, Nicolas</au><au>Guérot, Emmanuel</au><au>Dres, Martin</au><au>Sonneville, Romain</au><au>Lafourcade, Alexandre</au><au>Navarro, Vincent</au><au>Robert, Hélène</au><au>Azouvi, Philippe</au><au>Sharshar, Tarek</au><au>Bayen, Eleonore</au><au>Luyt, Charles-Edouard</au><aucorp>Hanox Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Disabilities of Survivors of Out-of-Hospital Cardiac Arrest: The Hanox Study</atitle><jtitle>Chest</jtitle><addtitle>Chest</addtitle><date>2021-02</date><risdate>2021</risdate><volume>159</volume><issue>2</issue><spage>699</spage><epage>711</epage><pages>699-711</pages><eissn>1931-3543</eissn><abstract>Long-term outcomes of awakened survivors of out-of-hospital cardiac arrest (OHCA) are poorly known.
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?
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).
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.
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.
ClinicalTrials.gov; No.: NCT02292147; URL: www.clinicaltrials.gov.</abstract><cop>United States</cop><pmid>32702410</pmid><doi>10.1016/j.chest.2020.07.022</doi><tpages>13</tpages></addata></record> |
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subjects | Aged Disabled Persons - statistics & numerical data Female Glasgow Coma Scale Glasgow Outcome Scale Humans Male Middle Aged Out-of-Hospital Cardiac Arrest - complications Out-of-Hospital Cardiac Arrest - therapy Paris Risk Factors Survivors - statistics & numerical data |
title | Long-Term Disabilities of Survivors of Out-of-Hospital Cardiac Arrest: The Hanox Study |
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