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Is frailty associated with long-term survival, neurological function and patient-reported outcomes after in-hospital cardiac arrest?: - A Swedish cohort study
Karolinska University Hospital, Sweden.
Capio S t Gorans Hospital, Sweden;Karolinska Institutet, Sweden.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Region Kalmar County, Sweden.ORCID iD: 0000-0003-4772-0067
Lund University, Sweden;Skåne University Hospital, Sweden.ORCID iD: 0000-0003-1860-1456
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2022 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 179, p. 233-242Article in journal (Refereed) Published
Abstract [en]

Background: Frailty is associated with poor 30-days survival after in-hospital cardiac arrests (IHCA). The aim was to assess how pre-arrest frailty was associated with long-term survival, neurological function and patient-reported outcomes in elderly survivors after IHCA.Methods: Patients aged >= 65 years with IHCA at Karolinska University Hospital between 2013-2021 were studied. Frailty was assessed by the Clinical Frailty Scale (CFS) based on clinical records and categorised into non-frail (1-4) or frail (5-7). Survival was assessed in days. Neurological function was assessed by the Cerebral Performance Category scale (CPC). A telephone interview was performed six months post-IHCA and included the questionnaires EuroQoL-5 Dimensions-5 Levels and Hospital Anxiety and Depression Scale.Results: Totally, 232 (28%) out of 817 eligible patients survived to 30-days. Out of 232, 65 (28%) were frail. Long-term survival was better for non-frail than frail patients (6 months (92% versus 75%, p-value < 0.01), 3 years (74% vs 22%, p-value < 0.01)). The vast majority of both non-frail and frail patients had unchanged CPC from admittance to discharge from hospital (87% and 85%, respectively, p-value 0.52). The 121 non-frail patients reported better health compared to 27 frail patients (EQ-VAS median 70 versus 50 points, p-value < 0.01) and less symptoms of depression than frail (16% and 52%, respectively, p-value < 0.01).Conclusion: Frail patients suffering IHCA survived with the same neurological function they had at admittance. Although one in five frail patients survived to three years, frailty was associated with a marked decrease in long-term survival as well as increased symptoms of depression and poorer general health.

Place, publisher, year, edition, pages
Elsevier, 2022. Vol. 179, p. 233-242
Keywords [en]
Elderly, Survival, IHCA, CFS, HADS, EQ-5D-5L
National Category
Nursing Cardiac and Cardiovascular Systems
Research subject
Health and Caring Sciences, Nursing
Identifiers
URN: urn:nbn:se:lnu:diva-117813DOI: 10.1016/j.resuscitation.2022.07.013ISI: 000880404500011PubMedID: 35843406Scopus ID: 2-s2.0-85135846514OAI: oai:DiVA.org:lnu-117813DiVA, id: diva2:1717488
Available from: 2022-12-08 Created: 2022-12-08 Last updated: 2024-01-11Bibliographically approved

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Israelsson, Johan

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