Cardiac Arrest Survivorship Research Hub

OBJECTIVES: To (1) identify cardiac arrest (CA) survivors' and their caregivers' stressors and coping and compensation strategies related to brain health and (2) gather feedback on a proposed brain health lifestyle intervention for this population. METHODS: We conducted two focus groups with dyads of CA survivors and their caregivers ( = 9 dyads) and ten interviews ( = 10 dyads), recruited from the Sudden Cardiac Arrest Foundation's Cardiac Arrest Survivor Alliance, BuildClinical, and provider referrals between 9/2024 and 5/2025. We purposefully sampled to include populations at-risk for cognitive decline based on race and ethnicity. We conducted rapid qualitative data analysis of our focus groups and interview transcripts. RESULTS: Dyads described several sources of brain health stress including survivors' cognitive changes, fear of further decline, and concerns about caregiver stress. Dyads reported using coping strategies including peer support, professional mental health treatment, acceptance strategies, and physical activity, and compensation strategies including delegating more tasks to the caregiver, using organizational aids, visual aids, and pacing strategies. Dyads endorsed proposed program content and recommended additional content on nutrition and diet, managing emotional distress, and psychoeducation on the impact of CA on the brain. CONCLUSION: Survivors and caregivers experience ongoing stressors related to brain health, though they develop coping and compensation strategies that merit further study.

AIMS: To describe the proportion and severity of fatigue among out-of-hospital cardiac arrest (OHCA) survivors and to investigate the association between age group (working-age 18-64 years vs ≥65 years) and fatigue. METHODS AND RESULTS: This cross-sectional study used data from the Danish Cardiac Survivorship (DANCAS) survey, including adult (≥18 years) OHCA survivors. Fatigue (the Modified Fatigue Impact Scale, MFIS), anxiety and depression (Hospital Anxiety and Depression Scale, HADS), and disability (WHO Disability Assessment Schedule, WHODAS 2.0) were assessed. Descriptive statistics characterised fatigue across age groups. Linear regression models (unadjusted and adjusted) investigated the association between age group and fatigue, reported as regression coefficients (β) and 95% confidence intervals (CI).In total, n = 1236 survivors (median age 67 years, IQR 57-74) were included, of whom 551 were of working age and 685 were ≥65 years. Working-age survivors reported significantly higher (worse) levels of fatigue (median 19, IQR 6-38) compared to those aged ≥65 years (median 13, IQR 5-28). Working age was significantly associated with higher fatigue scores after adjustment for sex and age (β 4.80, 95% CI 2.63-6.98). The association was reduced but remained statistically significant after further adjusting for anxiety, depression, and disability (β 1.57, 95% CI 0.22-2.92). CONCLUSION: Working-age OHCA survivors reported higher levels of fatigue compared with survivors aged ≥65 years, particularly in the non-physical domains. The association was reduced after adjustment, suggesting overlap between fatigue, psychological distress and disability. These findings highlight the need for multidimensional and age-specific assessment of post-OHCA fatigue.

Background/Objectives: A structured follow-up after out-of-hospital cardiac arrest (OHCA) is recommended, but implementation across regional networks remains challenging. REVIVE introduced a hub-and-spoke survivorship pathway in Lombardy. This 12-month formative implementation evaluation aimed to describe staged pathway progression, operational reach, attrition points, centre-level variation, and documented barriers to assessment completion. Methods: Adult OHCA survivors with Cerebral Performance Category (CPC) 1–2 or Modified Rankin Scale (mRS) ≤ 3 were considered eligible. The evaluation was structured using Proctor et al.’s implementation outcomes framework. Implementation outcomes were operationalised using prospectively collected pathway indicators: eligibility ascertainment, successful contact, T0 assessment completion, completion of planned assessment components, timeliness where available, and documented reasons for non-progression. Analyses were descriptive and used chi-square or Fisher’s exact tests for unadjusted centre-level comparisons. Results: Of the 1663 patients hospitalised, 1458 (87.7%) were recorded as deceased or having an unfavourable neurological outcome and were therefore outside the intended REVIVE target population. Among the remaining 205 patients, eligibility could not be determined for 78 (4.7% of the total cohort), and 127 (7.6%) met eligibility criteria. Of eligible survivors, 96 (75.6%) were contacted and 64 completed the T0 assessment (66.7% of contacted; 50.4% of eligible). Pavia showed higher observed rates of eligibility ascertainment, contact, and assessment completion than spoke centres, but these differences were unadjusted and should be interpreted as centre-level implementation variation rather than evidence of causal superiority. Conclusions: REVIVE initiated a structured regional pathway for post-OHCA follow-up, but first-year implementation was partial rather than definitive. The 50.4% T0 completion rate among eligible survivors should be interpreted as an initial internal implementation indicator, not as evidence of established feasibility, effectiveness, or regional benchmarking. Priorities for further optimisation include eligibility ascertainment, transfer of contact information, patient engagement, and spoke-site support for assessment delivery.