Quality of Life after Out-of-hospital Cardiac Arrest - A TOMAHAWK Substudy

Michelle Rossberg; Anne Freund; Tharusan Thevathasan; Carsten Skurk; Inke R Koenig; Maren Vens; Hanna Grube; Frank Sandig; Kathrin Klinge; Ibrahim Akin; Georg Fuernau; Christian Hassager; Uwe Zeymer; Michael R Preusch; Tobias Graf; Alexander Jobs; Suzanne de Waha; Holger Thiele; Janine Poess; Steffen Desch

doi:10.1093/ehjacc/zuaf093

Quality of Life after Out-of-hospital Cardiac Arrest - A TOMAHAWK Substudy

Michelle Rossberg, Anne Freund, Tharusan Thevathasan, Carsten Skurk, Inke R Koenig, Maren Vens, Hanna Grube, Frank Sandig, Kathrin Klinge, Ibrahim Akin, Georg Fuernau, Christian Hassager, Uwe Zeymer, Michael R Preusch, Tobias Graf, Alexander Jobs, Suzanne de Waha, Holger Thiele, Janine Poess, Steffen Desch

Abstract

BACKGROUND: The TOMAHAWK trial compared immediate coronary angiography with a delayed/selective strategy in 554 resuscitated patients with out-of-hospital cardiac arrest (OHCA) without ST-segment elevations. Mortality did not differ significantly between the two groups. In addition to survival, health-related quality of life (HRQoL) is a key outcome parameter for OHCA patients.

METHODS: The analysis included 169 survivors from the TOMAHAWK trial who completed both the 6-month and 12-month follow-up (6M-FU/12M-FU). HRQoL was assessed using a questionnaire based on the EuroQoL-5D-3L. This tool includes a visual analogue scale (EQ-VAS) ranging from 0 to 100 (worst to best imaginable subjective health) and a descriptive system with five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.

RESULTS: No relevant differences were found between patients in the immediate angiography group and those in the delayed/selective angiography group regarding EQ-VAS scores at 6M-FU (70 ± 21 vs. 74 ± 18) and 12M-FU (72 ± 19 vs. 74 ± 17). Patients reported the most problems with usual activities (33% and 38%, respectively), and the fewest limitations in self-care (18% and 17%, respectively) at 6M-FU. Women reported more problems than men in all five dimensions. Elderly patients (≥65 years) were more likely than younger OHCA survivors to indicate limitations in mobility, self-care, usual activities, and pain/discomfort.

CONCLUSIONS: OHCA survivors of the TOMAHAWK trial rated their HRQoL 6 and 12 months after the event as relatively good, but there were notable differences between women and men and between younger and elderly patients. The angiography strategy did not affect HRQoL. www.ClinicalTrials.gov : NCT02750462.

Original language	English
Journal	European heart journal. Acute cardiovascular care
ISSN	2048-8726
DOIs	https://doi.org/10.1093/ehjacc/zuaf093
Publication status	E-pub ahead of print - 25.06.2025

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10.1093/ehjacc/zuaf093

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Rossberg, M., Freund, A., Thevathasan, T., Skurk, C., Koenig, I. R., Vens, M., Grube, H., Sandig, F., Klinge, K., Akin, I., Fuernau, G., Hassager, C., Zeymer, U., Preusch, M. R., Graf, T., Jobs, A., de Waha, S., Thiele, H., Poess, J., & Desch, S. (2025). Quality of Life after Out-of-hospital Cardiac Arrest - A TOMAHAWK Substudy. European heart journal. Acute cardiovascular care. Advance online publication. https://doi.org/10.1093/ehjacc/zuaf093

@article{9d81bd2558514079b3a74e01bc54491c,

title = "Quality of Life after Out-of-hospital Cardiac Arrest - A TOMAHAWK Substudy",

abstract = "BACKGROUND: The TOMAHAWK trial compared immediate coronary angiography with a delayed/selective strategy in 554 resuscitated patients with out-of-hospital cardiac arrest (OHCA) without ST-segment elevations. Mortality did not differ significantly between the two groups. In addition to survival, health-related quality of life (HRQoL) is a key outcome parameter for OHCA patients.METHODS: The analysis included 169 survivors from the TOMAHAWK trial who completed both the 6-month and 12-month follow-up (6M-FU/12M-FU). HRQoL was assessed using a questionnaire based on the EuroQoL-5D-3L. This tool includes a visual analogue scale (EQ-VAS) ranging from 0 to 100 (worst to best imaginable subjective health) and a descriptive system with five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.RESULTS: No relevant differences were found between patients in the immediate angiography group and those in the delayed/selective angiography group regarding EQ-VAS scores at 6M-FU (70 ± 21 vs. 74 ± 18) and 12M-FU (72 ± 19 vs. 74 ± 17). Patients reported the most problems with usual activities (33% and 38%, respectively), and the fewest limitations in self-care (18% and 17%, respectively) at 6M-FU. Women reported more problems than men in all five dimensions. Elderly patients (≥65 years) were more likely than younger OHCA survivors to indicate limitations in mobility, self-care, usual activities, and pain/discomfort.CONCLUSIONS: OHCA survivors of the TOMAHAWK trial rated their HRQoL 6 and 12 months after the event as relatively good, but there were notable differences between women and men and between younger and elderly patients. The angiography strategy did not affect HRQoL. www.ClinicalTrials.gov : NCT02750462.",

author = "Michelle Rossberg and Anne Freund and Tharusan Thevathasan and Carsten Skurk and Koenig, {Inke R} and Maren Vens and Hanna Grube and Frank Sandig and Kathrin Klinge and Ibrahim Akin and Georg Fuernau and Christian Hassager and Uwe Zeymer and Preusch, {Michael R} and Tobias Graf and Alexander Jobs and {de Waha}, Suzanne and Holger Thiele and Janine Poess and Steffen Desch",

note = "{\textcopyright} The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].",

year = "2025",

month = jun,

day = "25",

doi = "10.1093/ehjacc/zuaf093",

language = "English",

journal = "European heart journal. Acute cardiovascular care",

issn = "2048-8726",

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Rossberg, M, Freund, A, Thevathasan, T, Skurk, C, Koenig, IR , Vens, M , Grube, H, Sandig, F, Klinge, K, Akin, I, Fuernau, G, Hassager, C, Zeymer, U, Preusch, MR, Graf, T, Jobs, A, de Waha, S, Thiele, H, Poess, J & Desch, S 2025, 'Quality of Life after Out-of-hospital Cardiac Arrest - A TOMAHAWK Substudy', European heart journal. Acute cardiovascular care. https://doi.org/10.1093/ehjacc/zuaf093

TY - JOUR

T1 - Quality of Life after Out-of-hospital Cardiac Arrest - A TOMAHAWK Substudy

AU - Rossberg, Michelle

AU - Freund, Anne

AU - Thevathasan, Tharusan

AU - Skurk, Carsten

AU - Koenig, Inke R

AU - Vens, Maren

AU - Grube, Hanna

AU - Sandig, Frank

AU - Klinge, Kathrin

AU - Akin, Ibrahim

AU - Fuernau, Georg

AU - Hassager, Christian

AU - Zeymer, Uwe

AU - Preusch, Michael R

AU - Graf, Tobias

AU - Jobs, Alexander

AU - de Waha, Suzanne

AU - Thiele, Holger

AU - Poess, Janine

AU - Desch, Steffen

N1 - © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].

PY - 2025/6/25

Y1 - 2025/6/25

N2 - BACKGROUND: The TOMAHAWK trial compared immediate coronary angiography with a delayed/selective strategy in 554 resuscitated patients with out-of-hospital cardiac arrest (OHCA) without ST-segment elevations. Mortality did not differ significantly between the two groups. In addition to survival, health-related quality of life (HRQoL) is a key outcome parameter for OHCA patients.METHODS: The analysis included 169 survivors from the TOMAHAWK trial who completed both the 6-month and 12-month follow-up (6M-FU/12M-FU). HRQoL was assessed using a questionnaire based on the EuroQoL-5D-3L. This tool includes a visual analogue scale (EQ-VAS) ranging from 0 to 100 (worst to best imaginable subjective health) and a descriptive system with five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.RESULTS: No relevant differences were found between patients in the immediate angiography group and those in the delayed/selective angiography group regarding EQ-VAS scores at 6M-FU (70 ± 21 vs. 74 ± 18) and 12M-FU (72 ± 19 vs. 74 ± 17). Patients reported the most problems with usual activities (33% and 38%, respectively), and the fewest limitations in self-care (18% and 17%, respectively) at 6M-FU. Women reported more problems than men in all five dimensions. Elderly patients (≥65 years) were more likely than younger OHCA survivors to indicate limitations in mobility, self-care, usual activities, and pain/discomfort.CONCLUSIONS: OHCA survivors of the TOMAHAWK trial rated their HRQoL 6 and 12 months after the event as relatively good, but there were notable differences between women and men and between younger and elderly patients. The angiography strategy did not affect HRQoL. www.ClinicalTrials.gov : NCT02750462.

AB - BACKGROUND: The TOMAHAWK trial compared immediate coronary angiography with a delayed/selective strategy in 554 resuscitated patients with out-of-hospital cardiac arrest (OHCA) without ST-segment elevations. Mortality did not differ significantly between the two groups. In addition to survival, health-related quality of life (HRQoL) is a key outcome parameter for OHCA patients.METHODS: The analysis included 169 survivors from the TOMAHAWK trial who completed both the 6-month and 12-month follow-up (6M-FU/12M-FU). HRQoL was assessed using a questionnaire based on the EuroQoL-5D-3L. This tool includes a visual analogue scale (EQ-VAS) ranging from 0 to 100 (worst to best imaginable subjective health) and a descriptive system with five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.RESULTS: No relevant differences were found between patients in the immediate angiography group and those in the delayed/selective angiography group regarding EQ-VAS scores at 6M-FU (70 ± 21 vs. 74 ± 18) and 12M-FU (72 ± 19 vs. 74 ± 17). Patients reported the most problems with usual activities (33% and 38%, respectively), and the fewest limitations in self-care (18% and 17%, respectively) at 6M-FU. Women reported more problems than men in all five dimensions. Elderly patients (≥65 years) were more likely than younger OHCA survivors to indicate limitations in mobility, self-care, usual activities, and pain/discomfort.CONCLUSIONS: OHCA survivors of the TOMAHAWK trial rated their HRQoL 6 and 12 months after the event as relatively good, but there were notable differences between women and men and between younger and elderly patients. The angiography strategy did not affect HRQoL. www.ClinicalTrials.gov : NCT02750462.

U2 - 10.1093/ehjacc/zuaf093

DO - 10.1093/ehjacc/zuaf093

M3 - Journal articles

C2 - 40557995

SN - 2048-8726

JO - European heart journal. Acute cardiovascular care

JF - European heart journal. Acute cardiovascular care

ER -

Quality of Life after Out-of-hospital Cardiac Arrest - A TOMAHAWK Substudy

Abstract

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