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Abstract(s)
Introdução: A paragem cardiorrespiratória (PCR) associa-se a morbilidade e mortalidade
elevadas, tendo um vasto espectro de sequelas. Diversos estudos têm foco na sobrevivência,
no entanto, para uma ressuscitação bem sucedida é necessário ainda que haja uma
qualidade de vida aceitável.
Objetivo: Estudar a qualidade de vida e performance status dos doentes que sobrevivem
a paragem cardiorrespiratória, tal como o tempo de sobrevida e perda de autonomia.
Métodos: É um estudo retrospetivo que incluiu os adultos tratados na UCI do CHUCB após
PCR entre 2015 e 2019. Procedeu-se à análise de dados do processo clínico de todos os
doentes e à aplicação de um questionário aos que estavam vivos, o qual incluiu o
questionário EQ-5D-3L da EuroQoL e o score de performance status da ECOG.
Resultados: Obteve-se um total de 97 doentes, com idade média de 75,74 anos. A taxa de
sobrevivência à alta hospitalar foi de 32,0% e a sobrevivência global a um ano foi de 20,6%.
O tempo de sobrevida médio nos doentes com alta foi de 31,26 meses, sendo que 64,3%
estavam vivos um ano após PCR. Depressão prévia(p=0,041), tempo de internamento
(p=0,030), dependência para atividades da vida diária após PCR (p=0,014) e
institucionalização após PCR (p=0,001) associaram-se a uma menor sobrevivência a um
ano. Verificou-se uma mudança significativa no nível de autonomia (p=0,000) e
institucionalização (p=0,004), havendo perda de autonomia em 50% dos previamente
autónomos. Na perda de autonomia, destaca-se o papel da diabetes mellitus (OR 33,519;
p=0,012) e tempo de internamento (OR 1,077; p=0,073). Já na institucionalização, destacase o sexo feminino (OR 19,016; p=0,048) e tempo de internamento (OR 1,052; p=0,052).
Dos doentes com sobrevida superior a um ano, 65% eram autónomos e 88% estavam no
domicílio. À data do estudo, 12 doentes estavam vivos e 9 participaram no questionário de
qualidade de vida. Apesar da maioria reconhecer uma diminuição da qualidade de vida, o
índice EQ-5D era comparável ao da população portuguesa com mais de 30 anos (p=0,762).
Os domínios mais afetados foram “Dor/mal-estar” e “Ansiedade/Depressão”. A maioria
destes doentes(78%) tinha uma boa performance status.
Conclusões: Apesar da baixa taxa de sobrevivência após ressuscitação, os doentes
sobreviventes apresentaram uma qualidade de vida semelhante à da restante população e
uma boa performance status. Além disso, uma grande porção dos doentes que sobrevivem
a longo prazo têm autonomia para as atividades da vida diária.
Background: Cardiac arrest is associated with high morbidity and mortality, as well as a wide range of sequelae. Many studies focus on survival, but a successful resuscitation may also imply an acceptable quality of life. Aim: To evaluate cardiac arrest survivors’ outcomes such as quality of life, performance status, survival curve, and loss of independence. Methods: This study is a retrospective study that includes adults treated in the ICU of CHUCB who survived cardiac arrest from 2015 to 2019. The study has two components: analysis of patient registries and questionnaire application. The last included EuroQoL’s EQ-5D-3L questionnaire and ECOG performance status score. Results: We included 97 patients in this study, with a mean age of 75,74 years. Survival to hospital discharge was 32% and overall one-year survival of 20,6%. Those who survived hospital discharge had a mean survival time of 31,26 months and one-year survival of 64,3%. Previous diagnosis of depression(p=0,041), length of hospital stay(p=0,030), no independence (p=0,014) and living in a long-term care facility(p=0,001) after cardiac arrest were associated with lower one-year survival. We found a significant loss of independence for daily living activities and admission to long-term care facilities after arrest. For instance, 50% of previously independent patients became dependent. Diabetes mellitus(OR 33,519; p=0,012) and length of hospital stay(OR 1,077;p=0,073) were the most relevant factors in the loss of independence. On the other hand, female gender(OR 19,016;p=0,048) and length of hospital stay (OR 1,052; p=0,052) were the ones with the most impact on the admission to long-term care facilities. Considering those who survived over a year, 65% were independent and 88% lived at home. At the time of this research, 12 patients were alive, and nine participated in our questionnaire. Although most participants reported a reduction in their quality of life, the EQ-5D index did not differ significantly from that of the Portuguese population over 30 years old(p=0,762). "Pain/discomfort" and "Anxiety/depression" were the most affected domains. Finally, most patients had a good performance status(78%). Conclusions: Despite the low survival rate after cardiac arrest and resuscitation, the survivors end up having a quality of life similar to the rest of the population and good performance status. Furthermore, the majority of long-term survivors have independence for daily living activities.
Background: Cardiac arrest is associated with high morbidity and mortality, as well as a wide range of sequelae. Many studies focus on survival, but a successful resuscitation may also imply an acceptable quality of life. Aim: To evaluate cardiac arrest survivors’ outcomes such as quality of life, performance status, survival curve, and loss of independence. Methods: This study is a retrospective study that includes adults treated in the ICU of CHUCB who survived cardiac arrest from 2015 to 2019. The study has two components: analysis of patient registries and questionnaire application. The last included EuroQoL’s EQ-5D-3L questionnaire and ECOG performance status score. Results: We included 97 patients in this study, with a mean age of 75,74 years. Survival to hospital discharge was 32% and overall one-year survival of 20,6%. Those who survived hospital discharge had a mean survival time of 31,26 months and one-year survival of 64,3%. Previous diagnosis of depression(p=0,041), length of hospital stay(p=0,030), no independence (p=0,014) and living in a long-term care facility(p=0,001) after cardiac arrest were associated with lower one-year survival. We found a significant loss of independence for daily living activities and admission to long-term care facilities after arrest. For instance, 50% of previously independent patients became dependent. Diabetes mellitus(OR 33,519; p=0,012) and length of hospital stay(OR 1,077;p=0,073) were the most relevant factors in the loss of independence. On the other hand, female gender(OR 19,016;p=0,048) and length of hospital stay (OR 1,052; p=0,052) were the ones with the most impact on the admission to long-term care facilities. Considering those who survived over a year, 65% were independent and 88% lived at home. At the time of this research, 12 patients were alive, and nine participated in our questionnaire. Although most participants reported a reduction in their quality of life, the EQ-5D index did not differ significantly from that of the Portuguese population over 30 years old(p=0,762). "Pain/discomfort" and "Anxiety/depression" were the most affected domains. Finally, most patients had a good performance status(78%). Conclusions: Despite the low survival rate after cardiac arrest and resuscitation, the survivors end up having a quality of life similar to the rest of the population and good performance status. Furthermore, the majority of long-term survivors have independence for daily living activities.
Description
Keywords
Paragem Cardiorrespiratória Perda de Autonomia Performance Status Qualidade de Vida Ressuscitação Cardiorrespiratória