Health-related quality of life one year after refractory cardiac arrest treated with conventional or extracorporeal CPR; a secondary analysis of the INCEPTION-trial

• Published in: Resuscitation plus Vol. 19; p. 100669
• Main Authors: van de Koolwijk, Anina F., Delnoij, Thijs S.R., Suverein, Martje M., Essers, Brigitte A.B., Hermanides, Renicus C., Otterspoor, Luuk C., Elzo Kraemer, Carlos V., Vlaar, Alexander P.J., van der Heijden, Joris J., Scholten, Erik, den Uil, Corstiaan A., Dos Reis Miranda, Dinis, Akin, Sakir, de Metz, Jesse, van der Horst, Iwan C.C., Winkens, Bjorn, Maessen, Jos G., Lorusso, Roberto, van de Poll, Marcel C.G.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.09.2024; Elsevier
• Subjects: Clinical Paper; Extracorporeal cardiopulmonary resuscitation; Health-related quality of life; Out-of-hospital cardiac arrest; Refractory arrest; Out-of-hospital cardiac arrest; Health-related quality of life; Refractory arrest; Extracorporeal cardiopulmonary resuscitation
• ISSN: 2666-5204; 2666-5204
• DOI: 10.1016/j.resplu.2024.100669

Prospective, trial-based data comparing health-related quality of life (HRQoL) in patients surviving out-of-hospital cardiac arrest (OHCA) through extracorporeal cardiopulmonary resuscitation (ECPR) or conventional CPR (CCPR) are scarce. We aimed to determine HRQoL during 1-year after refractory OHCA in patients treated with ECPR and CCPR. We present a secondary analysis of the multicenter INCEPTION-trial, which studied the effectiveness of ECPR versus CCPR in patients with refractory OHCA. HRQoL was prospectively assessed using the EQ-5D-5L questionnaire. Poor HRQoL was pragmatically defined as an EQ-5D-5L health utility index (HUI) > 1 SD below the age-adjusted norm. We used mixed linear models to assess the difference in HRQoL over time and univariable analyses to assess factors potentially associated with poor HRQoL. A total of 134 patients were enrolled, and hospital survival was 20% (27 patients). EQ-5D-5L data were available for 25 patients (5 ECPR and 20 CCPR). One year after OHCA, the estimated mean HUI was 0.73 (0.05) in all patients, 0.84 (0.12) in ECPR survivors, and 0.71 (0.05) in CCPR survivors (p-value 0.31). Eight (32%) survivors had a poor HRQoL. HRQoL was good in 17 (68%) patients, with 100% in ECPR survivors versus 60% in CCPR survivors (p-value 0.14). One year after refractory OHCA, 68% of the survivors had a good HRQoL. We found no statistically significant difference in HRQoL one year after OHCA in patients treated with ECPR compared to CCPR. However, numerical differences may be clinically relevant in favor of ECPR.