Is there life after hospital discharge for resuscitated cardiac arrest patients?

摘要

Out-of-hospital cardiac arrest affects 236,000 to 325,000 people in the United States annually and substantial regional variability in survival, probably as great as five-fold, has been demonstrated (1). The median survival rate, more specifically survival to hospital discharge, is about 7.9% nationally. As in most other studies of out-of-hospital cardiac arrest and resuscitation, this value does not take into account neurologic or functional status at time of discharge-an obviously important endpoint of interest to emergency medical services systems, physicians, and other healthcare providers, policy makers, and the public. The findings of the first clinical trial undertaken and reported by the Resuscitation Outcomes Consortium demonstrated a survival to hospital discharge rate of about 8%. Of those surviving to hospital discharge, 5.9% had a "satisfactory" functional status, denned as a modified Rankin Scale Score of less than or equal to 3 on a 0-6 point scale, at time of hospital discharge (2). For many survivors, a score of 3 (dependent existence) might not be considered satisfactory. These functional rates were not significantly different between control and treatment groups of the ROC trial.