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Article Dans Une Revue Chest Année : 2021

Long-Term Disabilities of Survivors of Out-of-Hospital Cardiac Arrest

Guillaume Hékimian
  • Fonction : Auteur
Nicolas Bréchot
  • Fonction : Auteur
Mathieu Schmidt
  • Fonction : Auteur
Alain Combes
Charles-Edouard Luyt
  • Fonction : Auteur
Alexandre Demoule
  • Fonction : Auteur
Martin Dres
  • Fonction : Auteur
Julien Mayaux
  • Fonction : Auteur
Anne Peskine
  • Fonction : Auteur
Hélène Robert
  • Fonction : Auteur
Pascale Pradat-Diehl
  • Fonction : Auteur
Eléonore Bayen
  • Fonction : Auteur
Vincent Navarro
  • Fonction : Auteur
Damien Galanaud
  • Fonction : Auteur
Nathalie Marin
  • Fonction : Auteur
Julien Charpentier
  • Fonction : Auteur
Alain Cariou
  • Fonction : Auteur
Jean-Paul Mira
  • Fonction : Auteur
  • PersonId : 928244
Olivier Vignaud
  • Fonction : Auteur
Emmanuel Guérot
  • Fonction : Auteur
Jean-Luc Diehl
  • Fonction : Auteur
Jean-Yves Fagon
  • Fonction : Auteur
Nicolas Deye
  • Fonction : Auteur
Jean-Pierre Guichard
  • Fonction : Auteur
Nathalie Kubis
  • Fonction : Auteur
Alain Yelnik
  • Fonction : Auteur
Romain Sonneville
  • Fonction : Auteur
Lila Bouadma
  • Fonction : Auteur
Jean-François Timsit
Isabelle Klein
  • Fonction : Auteur
Tarek Sharshar
  • Fonction : Auteur
Philippe Azouvi
  • Fonction : Auteur
Robert Carlier
  • Fonction : Auteur
Florence Colle
  • Fonction : Auteur

Résumé

Background: Long-term outcomes of awakened survivors of out-of-hospital cardiac arrest (OHCA) are poorly known.Research question: What are the month (M) 18 outcomes of survivors of out-of-hospital cardiac arrest (OHCA) who awakened during the first 2 weeks' post-OHCA and their poor-outcome risk factors?Study design and methods: All OHCA survivors with a Glasgow Coma Scale score ≥12 during the first 2 weeks' post-OHCA were enrolled in six ICUs and followed up at M3, M6, M12, and M18. The primary outcome measure was Glasgow Outcome Scale-Extended (GOS-E) score at M18. Secondary outcome measures included evaluation at M18 of neurologic, behavioral, and cognitive disabilities; health-related quality of life (HR-QOL), anxiety and depression; and poor-outcome risk factors (GOS-E score ≤ 6).Results: Among the 139 included patients, 98 were assessable for the primary outcome measure. At M18, 64 (65%) had full recovery or minor disabilities (GOS-E score > 6), 18 (18%) had moderate disabilities but were autonomous for daily-life activities (GOS-E score = 6), 12 (12%) had poor autonomy (GOS-E score < 6 but > 1), and four had died. Percentages of patients with GOS-E scores > 6 increased significantly over the 18-month study period. At M18, no patients had major neurologic disabilities, 20% had cognitive disabilities, 32% had anxiety symptoms, 25% had depression symptoms, and their HR-QOL was impaired compared with a sex- and age-matched population. Low-flow time, Sequential Organ Failure Assessment score at admission, coma duration > 3 days after cardiac arrest, and mechanical ventilation on days 3 and 7 were associated with poor functional outcome.Interpretation: Among patients who awoke (Glasgow Coma Scale score ≥12) in the 14 days following OHCA, 35% had moderate to severe disabilities or had died at M18. Interestingly, patients improved until M18 post-OHCA. Risk factors associated with poor functional outcome were low-flow time, clinical severity at ICU admission, prolonged coma duration, and mechanical ventilation.Clinical trial registration: ClinicalTrials.gov; No.: NCT02292147; URL: www.clinicaltrials.gov.
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Dates et versions

hal-03858591 , version 1 (22-03-2023)

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Paternité - Pas d'utilisation commerciale

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Anne Peskine, Alain Cariou, David Hajage, Nicolas Deye, Emmanuel Guérot, et al.. Long-Term Disabilities of Survivors of Out-of-Hospital Cardiac Arrest. Chest, 2021, 159 (2), pp.699-711. ⟨10.1016/j.chest.2020.07.022⟩. ⟨hal-03858591⟩
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