In cardiac arrest patients—in-hospital and pre-hospital—does resuscitation produce a good quality of life for survivors after discharge from the hospital? The answer, simply put, is yes, according to a systematic review of the literature published in this month's Resuscitation.
The researchers noted that much of the scientific literature underpinning resuscitation after cardiac arrest has focused on survival, "and much of this short-term survival."
There is a concern, they said, because despite the large sums of money invested to maximize the chance of survival from a cardiac arrest, reports suggest that patients experience a diminished existence—and "this would thus not justify the efforts and costs involved."
To study the topic, Vanessa J. Elliott, MD, from Imperial College Healthcare NHS Trust in London, and colleagues searched the literature for relevant articles.
They used nine inception (prospective) cohort studies, three follow-up of untreated control groups in randomized control trials, 11 retrospective cohort studies and 47 case series. Overall, 46 studies supported the hypothesis that resuscitation after cardiac arrest leads to a good quality of life after discharge from hospital; 17 studies were neutral to the hypothesis and seven studies provided evidence to the contrary.
"There was no overwhelming evidence from this review that resuscitating people after cardiac arrest led to a large pool of patients that experienced an unbearably poor quality of life," researchers concluded.
Elliott and colleagues also noted that their review "demonstrated a remarkable heterogeneity of methodology among studies assessing quality of life in cardiac arrest survivors, with nothing approaching a consensus or consistent approach discernable."
This problem, they said, may be unavoidable as quality of life and its assessment is complex. However, they found much variability in outcome measures used to assess quality of life, which is in "marked contrast to the approach recommended for other aspects of resuscitation reporting."
They concluded, "We are now in an era of intervention in resuscitation research and of financial frugality more generally, thus such a standardized approach, which might include data designed to inform a health economic evaluation, is urgently needed."