Two simple questions to assess neurologic outcomes at 3 months after out-of-hospital cardiac arrest: Experience from the Public Access Defibrillation Trial☆
Received 3 September 2009; received in revised form 13 January 2010; accepted 18 January 2010. published online 22 February 2010.
Abstract
Background
Two simple questions have been used to classify neurologic outcome in patients with stroke. Could they be similarly applied to patients with cardiac arrest?
Methods
As part of a randomized trial, study personnel interviewed by telephone survivors of out-of-hospital cardiac arrest to assess their outcomes 3 months after discharge. They asked two simple questions: (1) In the last 2 weeks, did you require help from another person for your everyday activities? and (2) Do you feel that you have made a complete mental recovery form your heart arrest? Next they administered the Mini-Mental State Examination (MMSE) from the Adult Lifestyles and Function Interview (ALFI) to assess cognition on a scale from 0 to 22 and the Health Utilities Index Mark 3 (HUI3) to assess quality of life on a scale from 0 (death) to 1 (perfect health).
Results
Based on responses to the two simple questions, 32 survivors were classified as dependent (n=5, 16%), independent (n=3, 9%) and full recovery (n=24, 75%). The mean ALFI-MMSE score was 19.1 (standard deviation 5.1), and the mean HUI3 score was 0.76 (standard deviation 0.28). The classification based on the two simple questions was significantly correlated with ALFI-MMSE (p=0.002) and HUI3 (p=0.001). Scores for the HUI3 were missing in eight survivors.
Conclusions
Neurologic outcomes based on the two simple questions after cardiac arrest can be easily determined, sensibly applied, and readily interpreted. These preliminary findings justify further evaluation of this simple and practical approach to classify neurologic outcome in survivors of cardiac arrest.
aDepartment of Neurology, School of Medicine, University of Washington, Seattle, WA, United States
bDepartment of Medicine, School of Medicine, University of Washington, Seattle, WA, United States
cDepartment of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA, United States
dDepartment of Biostatistics, School of Public Health and Community Medicine, University of Washington, Seattle, WA, United States
Corresponding author at: Department of Neurology, Box 359775, Harborview Medical Center, 325 Ninth Avenue, Seattle, WA 98104-2420, United States. Tel.: +1 206 744 3251; fax: +1 206 744 8787.
ABSTRACT