Abstract
Introduction
Rehabilitation outcomes in cardiac arrest survivors are largely unknown, with no data
comparing out-of-hospital cardiac arrests (OHCA) and in-hospital cardiac arrests (IHCA).
This study aimed to describe and compare inpatient rehabilitation outcomes in these
patients who were admitted from intensive care units (ICU).
Methods
A retrospective linkage and analysis of cardiac arrest patients in the Australian
and New Zealand Intensive Care Society Adult Patient Database and the Australasian
Rehabilitation Outcomes Centre inpatient dataset discharged to inpatient rehabilitation
between January 2017 and June 2018. Primary outcome was the functional improvement
during rehabilitation (difference between the Functional Independence Measurement
(FIM) score on admission and discharge). Multivariate regression analyses were performed
to determine factors associated with functional improvement.
Results
In the 240 (84 OHCA and 156 IHCA) patients included, the median length of inpatient
rehabilitation was 15 days [1st–3rd quartile (Q1-Q3): 9–24]. OHCA patients were more
likely to be admitted to rehabilitation for neurological issues (41.7%) and IHCA for
medical reasons (51.9%). Median (Q1-Q3) change in total FIM scores was similar between
the two groups (24.5[10–37]) vs 21[11–31], adjusted p = 0.20), with most of the FIM
change seen in the motor items, and this was only associated with a lower admission
FIM score. The majority of OHCA and IHCA patients were discharged home (91.5% and
89.7%, respectively), although with an increased need for a carer at home compared
to baseline (27.2% to 55.6%).
Conclusion
Patients discharged from ICU following OHCA and IHCA achieved reasonable and similar
functional improvement during inpatient rehabilitation.
Keywords
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Article info
Publication history
Published online: September 15, 2021
Accepted:
September 6,
2021
Received in revised form:
August 17,
2021
Received:
April 21,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Testing the strength of the last link in the Chain of SurvivalResuscitationVol. 169
- PreviewWith more than 180.000 out-of-hospital cardiac arrests (OHCA) and 200.000 in-hospital cardiac arrests (IHCA) occurring annually in the United States and only 11% of OHCA and 26% of IHCA patients surviving to hospital discharge,1 much research in cardiac arrest has focused on improving early and acute interventions in the Chain of Survival, namely increasing early bystander interventions and reducing ambulance response times.2 Arguably, this has contributed to the promising increase seen in survival following cardiac arrest over the last decade.
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