Cardiac Arrest Survivorship
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Background As survival rates for sudden cardiac arrest (SCA) have increased, so has the imperative for advancing survivorship support. Previous work suggests a massive gap in understanding of post-acute care needs and how best to support survivors and families (co-survivors) after hospital discharge. Although clinical models for post-SCA care exist, there have been few studies that seek to understand cardiac arrest survivor and importantly co-survivor experiences. Applying qualitative methods can be valuable to identify opportunities for developing tailored support that is grounded in the needs and experiences of survivors and co-survivors. Aims This study aimed to specifically understand out-of-hospital cardiac arrest (OHCA) survivor and co-survivor perspectives, experiences and support needs during the first year of their survivorship journey and to identify pain points where digital interventions could play a role in enhancing survivorship experiences. Methods We used an interpretive descriptive approach to qualitative inquiry within an overarching co-design process. As an additional means of triangulation, focus groups and individual interviews with clinicians and rehabilitation specialists were also conducted. Results Survivors (n = 9) and spouses (n = 5) of survivors, averaging 7.71 years since SCA, participated in four focus groups. One focus group and two individual interviews were conducted among six clinicians. Two major themes reflect OHCA (co-)survivorship experiences and support needs: (1) navigating new territory without a map, and (2) the impact of time and evolution of needs. Within each theme, several sub-themes indicate pain points for OHCA survivors and co-survivors, highlighting specific opportunities to design support that enhances recovery experiences for both. Conclusions By first understanding survivor and co-survivor experiences of recovery along with where they felt supports were missing, we identified key pain points that represent opportunities for enhancing recovery experiences through digital health. The results of this work contribute significantly to the broader cardiac arrest survivorship agenda by not only confirming key challenge areas, support needs and “turning points” of cardiac arrest survivors and co-survivors but highlighting the novel concept of the evolution of survivorship needs over time, a key consideration for intervention development.

AIM: To assess cognitive function, health-related quality of life (HRQoL), reintegration into daily life, and psychological outcomes among out-of-hospital cardiac arrest (OHCA) survivors. METHODS: Data were obtained from the multicenter German Cardiac Arrest Registry (G-CAR). Survivors completed standardized assessments at 6- and 12-month follow-up (6M-FU; 12M-FU), including 1.) Mini Montreal Cognitive Assessment (Mini-MoCA), 2.) EuroQol 5 Dimension 5 Level (EQ-5D-5L), 3.) Hospital Anxiety and Depression Scale (HADS), 4.) Reintegration to Normal Living Index (RNLI), and 5.) Posttraumatic Stress Symptoms-14 (PTSS-14). RESULTS: Among 1,644 OHCA patients enrolled between July 2021 and August 2024, 416 survived to hospital discharge. Follow-up data were available for 354 patients at 6 months and 307 at 12 months. Cognitive impairment was identified in 30.5% and 33.6% of respondents at 6 and 12 months, respectively. HRQoL was generally favorable, with at least 75% reporting no or slight limitations across EQ-5D-5L dimensions and mean index values comparable to those of the age-matched German population (6M-FU: 0.83 ± 0.24; 12M-FU: 0.84 ± 0.23). Reintegration into normal living was high (RNLI; 6M-FU 37.9 ± 7.3; 12M-FU: 38.4 ± 6.9). Most participants had normal HADS scores, although 13% reported abnormal depressive symptom scores. Mean PTSS-14 scores remained below the threshold suggestive of post-traumatic stress disorder at both follow-ups (6M-FU: 30.9; 12M-FU: 31.3). CONCLUSION: OHCA survivors generally reported good long-term quality of life, successful social reintegration, and low psychological distress. However, persistent cognitive impairment and depressive symptoms affected a substantial proportion of survivors, highlighting the importance of structured long-term follow-up after OHCA. CLINICALTRIALS: gov identifier: NCT05142124.

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