QUALITY-OF-LIFE AFTER CARDIOPULMONARY-RESUSCITATION

Objectives: This study evaluates the influence of Cardiopulmonary Resuscitation (CPR) on the components of quality of life (QOL) of patients after discharge from the hospital. Design: Extracted from a prospective national survey on Dutch intensive care units (ICUs). Setting: Thirty-six ICUs of both university and nonuniversity hospitals, spread throughout the country. Methods: For a period of 6 months, 9,803 consecutive ICU admissions entered the study. Outcome in connection with in-hospital CPR was analyzed by comparing the CPR group (n=477) with a standardized control group without CPR (n=500). Interventions: Activities of daily living were registered at the time of hospital admission. A record was kept of each patient for demographics, severity of illness,length of stay, daily use of manpower and ICU technology, and mortality. Six months after hospital discharge, the QOL of 69 patients in both the CPR and control groups was measured with the Sickness Impact Profile (SIP). Results: CPR was performed in 4.8 percent of the patients, mainly from the general ward. These patients were older, had a higher severity of illness, and a higher daily consumption of nursing resources. The QOL did not correlate with severity of illness on admission, length of stay, or consumption of resources in the ICU. On the whole, the SIP scores of both CPR and control groups did not differ much: 11.7 vs 10.7, and circulatory arrest did not appear to impair the self-sufficiency in the study group significantly in comparison with the controls. An increased dysfunction was found in the CPR group of patients concerning their work and their psychosocial functioning. Conclusion: Patients who have recovered from a circulatory arrest after CPR resuscitation find their capacity for resuming work diminished after discharge from the hospital, while they seem to experience a postponed negative effect on their mental functioning, especially the functions connected with the awareness of their environment.