Background

Self-reported health and life satisfaction are considered important outcomes in people surviving cardiac arrest. However, most previous studies have reported limited aspects on health, often based on composite scores, and few studies have focused on life satisfaction. Investigating health aspects with a broad and detailed perspective is important to increase the knowledge of life after cardiac arrest from the perspective of survivors. In addition, the knowledge of potential differences in health among survivors related to place of arrest (in-hospital cardiac arrest; IHCA or out-of-hospital cardiac arrest; OHCA) is scarce. The aim was to describe and compare self-reported health and life satisfaction in IHCA and OHCA survivors.

Methods

This observational cross-sectional study included adult cardiac arrest survivors six months after resuscitation, treated at five Swedish hospitals between 2013 and 2018. Participants received a study specific questionnaire including Health Index (HI), EQ-5D 5 Levels (EQ-5D-5L), Minimal Insomnia Sleeping Scale (MISS), Multidimensional Scale of Perceived Social Support (MSPSS), Hospital Anxiety and Depression Scale (HADS), and Satisfaction With Life Scale (SWLS). In order to present characteristics descriptive statistics were applied. The Mann-Whitney U test, chi-square test or Fishers' exact test were used to compare differences in self-reported health and life satisfaction between in-hospital- and out-of-hospital cardiac arrest survivors

Results

In total, 212 survivors participated. Based on scale scores and general measures, the median scores of health and life satisfaction among survivors were high: HI total = 29, EQ VAS = 80, and SWLS = 20. According to HI, most problems were reported for tiredness (37.3 %) and strength (26.4 %), while pain/discomfort (57.5 %) and anxiety/depression (42.5 %) where most common according to EQ-5D-5L. Except for EQ-5D-5L mobility (p = 0.023), MSPSS significant other (p = 0.036), and MSPSS family (p = 0.043), no health differences in relation to place of arrest were identified.

Conclusions

Although general health and life satisfaction were good among cardiac arrest survivors, several prevalent health problems were reported regardless of place of arrest. To achieve an improved understanding of health in cardiac arrest survivors, it is important to assess specific symptoms as a complement to composite scores of general, physical, emotional, and social health.

Background: Insomnia symptoms seem to be common in cardiac arrest survivors but their associations with important outcomes such as self reported health and life satisfaction have not previously been reported during the early post-event period. Therefore, the aim of the study was to investigate whether symptoms of insomnia are associated with self-reported health and life satisfaction in cardiac arrest survivors six months after the event.Methods: This multicentre cross-sectional survey included cardiac arrest survivors =18 years. Participants were recruited six months after the event from five hospitals in southern Sweden, and completed a questionnaire including the Minimal Insomnia Symptom Scale, EQ-5D-5L, Health Index, Hospital Anxiety and Depression Scale, and Satisfaction With Life Scale. Data were analysed using the Mann-Whitney U test, linear regression, and ordinal logistic regression. The regression analyses were adjusted for demographic and medical factors.Results: In total, 212 survivors, 76.4% males, with a mean age of 66.6 years (SD = 11.9) were included, and of those, 20% reported clinical insomnia. Insomnia was significantly associated with all aspects of self-reported health (p < 0.01) and life satisfaction (p < 0.001), except mobility (p = 0.093), self-care (p = 0.676), and usual activities (p = 0.073).Conclusion: Insomnia plays a potentially important role for both health and life satisfaction in cardiac arrest survivors. Screening for sleep problems should be part of post cardiac arrest care and follow-up to identify those in need of further medical examination and treatment.

Aim: To explore longitudinal variations in self-reported health and life satisfaction, with a particular focus on insomnia, over a 24-month period following cardiac arrest. 

Methods and results: This longitudinal multicentre study included 212 cardiac arrest survivors recruited from five hospitals in Sweden. Data were collected via postal questionnaires at 6, 12, and 24 months post-arrest. Measures included EQ VAS and Health Index (HI), Hospital Anxiety and Depression Scale (HADS), Satisfaction With Life Scale (SWLS), and Minimal Insomnia Symptom Scale (MISS). Linear mixed-effects models and McNemar’s test were used to examine changes over time.  General health measured by EQ VAS remained stable, whereas HI declined significantly over time. Depressive symptoms increased significantly, while anxiety and life satisfaction showed no significant changes. No changes in insomnia symptoms were shown between the tree assessments, while a significant declined was precent in non-restorative sleep between the 6- and 24-months assessments. At the 24-month assessment, 25.6% of participants reported clinical insomnia. 

Conclusion: Although most cardiac arrest survivors reported good health and life satisfaction, a substantial proportion experienced persistent problems, particularly insomnia. These difficulties were not transient but appeared to persist or worsen over time, potentially undermining recovery.

Introduction: Cardiac arrest (CA) survivors often face significant health challenges, including insomnia, which can adversely affect their healthrelated quality of life. The Minimal Insomnia Symptom Scale (MISS) is a brief, self-reported instrument designed to screen for insomnia. This study aimed to identify the measurement properties of the MISS in CA survivors and to explore a relevant cut-off score. Methods: Data were collected from two studies: a health survey of CA survivors and a sub-study of a randomized controlled trial (RCT) on targeted temperature management (TTM2). A total of 269 CA survivors participated, with 212 from the survey and 57 from the RCT, the data was collected 6- 7 months after CA. The MISS was evaluated using the polytomous Rasch model, focusing on model fit, local independence, response category functioning, targeting, reliability, and differential item functioning (DIF). Results: In total, 212 participants were males and 57 females, with a mean age of 66 years. Overall, 51% had survived in-hospital CA and 49% outof-hospital CA. The MISS exhibited acceptable model fit and targeting, with no disordered thresholds or DIF for age, sex, or place of arrest. The reliability was acceptable. The suggested optimal cut-off score for identifying insomnia was >6 points. Conclusions: The findings indicate that MISS is a valid and reliable screening instrument for insomnia in CA survivors. These results support the use of MISS for screening insomnia in CA survivors.