Introduction

Rehabilitation outcomes in cardiac 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 [1^st – 3^rd 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.

中文翻译：

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澳大利亚和新西兰住进 ICU 的心脏骤停幸存者的康复结果 (ROSC ANZ)：一项数据关联研究

介绍

心脏幸存者的康复结果在很大程度上是未知的，没有比较院外心脏骤停 (OHCA) 和院内心脏骤停 (IHCA) 的数据。本研究旨在描述和比较这些从重症监护病房 (ICU) 入住的患者的住院康复结果。

方法

澳大利亚和新西兰重症监护协会成人患者数据库和澳大利亚康复结果中心住院患者数据集在 2017 年 1 月至 2018 年 6 月期间出院到住院康复的心脏骤停患者的回顾性链接和分析。 主要结果是康复期间的功能改善（差异入院和出院时的功能独立性测量 (FIM) 分数之间）。进行多变量回归分析以确定与功能改善相关的因素。

结果

在240（84 OHCA和156 IHCA）的患者包括，住院康复的中值长度是15天[1^日- 3^次四分位数（Q1-Q3）：9-24]。OHCA 患者更有可能因神经问题 (41.7%) 和 IHCA (51.9%) 接受康复治疗。两组 FIM 总分的中位数 (Q1-Q3) 变化相似（24.5[10-37] 与 21[11-31]，调整后 p=0.20），大部分 FIM 变化见于运动项目，这仅与较低的录取 FIM 分数有关。大多数 OHCA 和 IHCA 患者出院回家（分别为 91.5% 和 89.7%），尽管与基线相比（27.2% 至 55.6%）在家中需要照顾者有所增加。

结论

OHCA 和 IHCA 后从 ICU 出院的患者在住院康复期间获得了合理且相似的功能改善。