Challenges in activities of daily living in out-of-hospital cardiac arrest survivors from hospital discharge to everyday life: A prospective cohort study.

Abstract

BACKGROUND: Out-of-hospital cardiac arrest (OHCA) survivors face important challenges when performing activities of daily living (ADL). The aim was to describe the ADL ability among OHCA survivors at discharge from hospital, characteristics of OHCA survivors with decreased ADL ability, and changes in ADL ability over time. METHODS: In this prospective cohort study, OHCA survivors were recruited and followed for 6 months. Observed ADL ability was evaluated prior to hospital discharge and at 6-month follow-up using the Assessment of Motor and Process Skills (AMPS), and self-reported ADL ability with the ADL Interview (ADL-I). Characteristics were compared between 2 groups: Participants with decreased observed ADL ability below age norms at hospital discharge and those meeting or exceeding age norms. RESULTS: Of the 156 OHCA survivors included, 125 completed the 6-month follow-up. At hospital discharge, 78% had observed ADL motor skills, and 47% ADL process skills below the competence thresholds. In total, 38% of the participants had an observed ADL ability below age norms. These participants were older and had lower cognitive scores at discharge compared to those meeting or exceeding the age norms. At hospital discharge, 89% reported decreased personal ADL ability, particularly in transferring, personal hygiene, body care, and dressing. Over 6 months, most participants improved in both their observed and self-reported ADL ability, although 11% still had an ability below age norm. CONCLUSIONS: Most OHCA survivors experienced decreased observed and self-reported ADL ability at hospital discharge and, despite improvement, decreased ADL ability persisted even after 6 months in some OHCA survivors.