Functional status and quality of life (QoL) in long-term survivors of cardiac arrest after cardiac surgery
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KeywordsFunctional Status Cardiac Arrest NYHA Class Nottingham Health Profile Sudden Cardiac Arrest
We assessed long-term survival, functional status and QoL in cardiac surgery patients who survived after cardiac arrest during the immediate postoperative period. Of 3982 patients undergoing cardiac surgery over a 30-month period, 29 patients (0.7%) had a sudden cardiac arrest. Of these, 27 patients (93%) were successfully resuscitated with closed or open cardiopulmonary resuscitation (CPR). Overall, four patients (14%) survived the CPR but died in the ICU, and 23 patients (79%) survived to hospital discharge. At reevaluation four years later, 16 patients were still alive, yielding an overall four-year survival rate of 55%, while seven patients had died; of these last seven patients, three (43%) died during the first year and the remaining at various time intervals. The New York Heart (NYHA) classification and a questionnaire based on the Nottingham Health Profile (NHP) were used to investigate functional status and QoL in these 16 long-term survivors. Of these, 12 patients (75%) were in NYHA class I, three patients (19%) in NYHA class II and one patient (6%) in NYHA class III. None of the patient reported any emotional problems, signs of social isolation or difficulties in physical mobility. Six patients (38%) had exertional angina and six patients (38%) reported mild sleep disturbances, such as early awaking. All but two patients had retired (taking advantage of the available laws), 15 patients (94%) were able to look after their home, 10 patients (63%) had a sexual activity, 13 patients (81%) were active with their special interests or hobbies, and 12 patients (75%) had gone on holidays. In conclusion, more than 50% of post-cardiac surgery patients who survive after cardiac arrest occurring in the immediate postoperative period have a good functional status and a preserved quality of life up to 4 years following cardiac arrest and successful CPR.