Physical, psychological, cognitive, social health outcomes, and health-related quality of life in out-of-hospital cardiac arrest survivors and co-survivors: 3-month outcomes from the Quality Cardiac Arrest Survivorship cohort study (QualiCAS)

Abstract

Background: Survivors and co-survivors of out-of-hospital cardiac arrest (OHCA) experience disruptions in returning to normality. There is limited understanding of OHCA-related sequelae and their impact on co-survivors. This study describes the 3-month post-discharge health outcomes among OHCA survivors and co-survivors in the Quality Cardiac Arrest Survivorship cohort study (QualiCAS). Methods: We conducted a prospective, population-based cohort study, enrolling subjects from 1 February 2023 to 30 November 2024. Physical, psychological, cognitive, and social health, health-related quality of life (HRQoL), and caregiver burden were described separately for survivors and co-survivors. HRQoL of survivors and co-survivors was compared against age-, sex-, and ethnicity-adjusted Singapore population norm for EQ-5D-5L. Results: 62 survivors and 36 co-survivors completed 3-month assessments. 9.7%, 6.5%, 3.6% of survivors screened positive for anxiety, depression, and post-traumatic stress disorder (PTSD), respectively. Survivors experienced mild cognitive impairment (43.1%), impaired mobility (41.1%), and weak muscle strength (39.7%). Functional independence was high, and 73.9% of survivors returned to employment. Survivors' HRQoL was lower compared to the general population (0.90 vs. 0.96). Co-survivors reported experiencing caregiving burden (41.7%), with 22.2%, 11.1% and 6.1% screening positive for anxiety, depression, and PTSD, respectively. Co-survivors' HRQoL was comparable to the general population (0.94 vs. 0.94). Conclusion: A significant subset of OHCA survivors experienced limitations in physical and cognitive functioning and return to work, and lower HRQoL. Psychological distress and caregiving burden were high among co-survivors. Our findings underscore the importance of systematic assessments of multi-dimensional aspects of health and referral to multi-component rehabilitation for both survivors and co-survivors.