Background

Frailty is associated with poor 30-days survival after in-hospital cardiac arrests (IHCA). The aim was to assess how pre-arrest frailty was associated with long-term survival, neurological function and patient-reported outcomes in elderly survivors after IHCA.

Methods

Patients aged ≥65 years with IHCA at Karolinska University Hospital between 2013-2021 were studied. Frailty was assessed by the Clinical Frailty Scale (CFS) based on clinical records and categorised into non-frail (1-4) or frail (5-7). Survival was assessed in days. Neurological function was assessed by the Cerebral Performance Category scale (CPC). A telephone interview was performed six months post-IHCA and included the questionnaires EuroQoL-5 Dimensions-5 Levels and Hospital Anxiety and Depression Scale.

Results

Totally, 232 (28%) out of 817 eligible patients survived to 30-days. Out of 232, 65 (28%) were frail. Long-term survival was better for non-frail than frail patients (6months (92% versus 75%, p-value <0.01), 3 years (74% vs 22%, p-value <0.01)). The vast majority of both non-frail and frail patients had unchanged CPC from admittance to discharge from hospital (87% and 85%, respectively). The 121 non-frail patients reported better health compared to 27 frail patients (EQ-VAS median 70 versus 50 points, p-value <0.01) and less symptoms of depression than frail (16% and 52%, respectively, p-value <0.01).

Conclusion

Frail patients suffering IHCA survived with largely unchanged neurological function. Although one in five frail patients survived to three years, frailty was associated with a marked decrease in long-term survival as well as increased symptoms of depression and poorer general health.

中文翻译：

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体弱是否与院内心脏骤停后的长期生存、神经功能和患者报告的结果相关？- 瑞典队列研究

背景

虚弱与院内心脏骤停 (IHCA) 后的 30 天存活率差有关。目的是评估 IHCA 后老年幸存者的逮捕前虚弱与长期生存、神经功能和患者报告的结果之间的关系。

方法

研究了 2013 年至 2021 年间在卡罗林斯卡大学医院接受 IHCA 的 65 岁以上的患者。衰弱是根据临床记录通过临床衰弱量表 (CFS) 评估的，并分为非衰弱 (1-4) 或衰弱 (5-7)。以天为单位评估存活率。神经功能通过大脑表现类别量表 (CPC) 进行评估。在 IHCA 后 6 个月进行了电话采访，包括问卷 EuroQoL-5 Dimensions-5 水平和医院焦虑和抑郁量表。

结果

总共有 817 名符合条件的患者中有 232 名（28%）存活了 30 天。在 232 人中，有 65 人（28%）身体虚弱。非体弱患者的长期生存率优于体弱患者（6 个月（92% 对 75%，p 值 <0.01）、3 年（74% 对 22%，p 值 <0.01））。绝大多数非体弱和体弱患者的 CPC 从入院到出院均未发生变化（分别为 87% 和 85%）。与 27 名体弱患者相比，121 名非体弱患者报告的健康状况更好（EQ-VAS 中位数 70 分对 50 分，p 值 <0.01），抑郁症状比体弱者少（分别为 16% 和 52%，p 值 < 0.01)。

结论

患有 IHCA 的虚弱患者在神经功能基本没有变化的情况下幸存下来。虽然五分之一的体弱患者存活至三年，但体弱与长期生存率显着下降以及抑郁症状增加和整体健康状况较差有关。