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

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.