Functional status and quality of life in long-term survivors of cardiac arrest after cardiac surgery

Objective: To assess long-term survival, functional status, and quality of life in patients who experienced cardiac arrest after cardiac surgery. Design: Prospective, observational study. Setting: An 18-bed, adult cardiac surgery intensive care unit in a tertiary teaching center. Patients: Twenty-nine cardiac surgery patients who suffered an unexpected cardiac arrest in the immediate postoperative period. Interventions: The New York Heart Association classification and a questionnaire based on the Nottingham Health Profile were used to evaluate functional status and quality of life 4 yrs after hospital discharge. Measurements and Main Results: Of the 29 patients who experienced cardiac arrest during the first 24 hrs after cardiac surgery, 27 patients (93%) were successfully resuscitated and 23 patients (79%) survived to hospital discharge. Evaluation 4 yrs postdischarge showed that, of the 29 patients, 16 patients (55%) were still alive (long-term survivors). Functional status assess-ment of long-term survivors revealed that 12 patients (75%) were grouped in New York Heart Association class I, 3 patients (19%) in class II, and 1 patient (6%) in Glass III. None of them had a neurologic deficit. They all were living independently at home, without need of any nursing care, No patient reported any abnormal emotional reactions, and six patients (38%) had mild sleep disturbances, such as early awaking. Regarding activities of daily living, 20% returned to work, 94% were able to look after their home, 96% had a social life, 63% were sexually active, 81% were involved in their hobbies, and 75% had gone on holidays. Conclusions: Cardiac surgery patients who experience an unexpected cardiac arrest in the immediate postoperative period have a 55% chance of being alive 4 yrs postdischarge. The majority of these long-term survivors has a good outcome with respect to functional status and quality of life.