Long-term disability level of 1-month survivors after out-of-hospital cardiac arrest: a nationwide cohort study in Korea using data from 2009 to 2018

Abstract

Recent guidelines identified recovery from cardiac arrest as an additional link in the chain of survival. However, data on the disability level and long-term survivorship in such patients are limited. We aimed to determine the long-term disability level, including disability type and severity, in patients with out-of-hospital cardiac arrest (OHCA) 1 month after discharge. This nationwide observational study used data from the National Health Insurance Service of Korea. We included adult OHCA patients who presented to the emergency departments (ED) of all hospitals in Korea between 2009 and 2018. The main outcome was disability level between 1 month after discharge and the 2-year follow-up. The average disability level was divided into six grades: most severe (grade 1) to mild (grade 6). Among 224,520 OHCA patients, 25,598 (11.4%) survived at 30 days. After excluding 3143 patients with a follow-up less than 2 years, 22,455 patients were included. Newly-developed disabilities were observed in 2664 patients (11.9%) and were more frequent in 1-year survivors than non-survivors (16.7% vs. 4.4%, p < 0.01). The most common type of disability was encephalopathic (54.2%), followed by renal (16.1%), physical (10.5%), and cardiac (4.2%) disabilities. Grade 1 disability was most frequent, followed by grade 2 and 3 (45.7%, 23.5%, 10.9%, respectively). Among patients who survived at 30 days after OHCA, 11.9% developed disabilities, including encephalopathic, physical, renal, and cardiac disabilities. Physicians should be aware of the risk of these disabilities and efforts to treat these disabilities in OHCA survivors should be increased.