Cognition, Quality of Life, and Psychological Outcomes in Out-of-Hospital Cardiac Arrest Survivors - Results from the German Cardiac Arrest Registry (G-CAR).

Abstract

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.