Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Is frailty associated with long-term survival, neurological function and patient-reported outcomes after in-hospital cardiac arrest? – A Swedish cohort study

Jonsson, Hanna ; Piscator, Eva ; Israelsson, Johan ; Lilja, Gisela LU and Djärv, Therese (2022) In Resuscitation 179. p.233-242
Abstract

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... (More)

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 (6 months (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, p-value 0.52). 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 the same neurological function they had at admittance. 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.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
CFS, Elderly, EQ-5D-5L, HADS, IHCA, Survival
in
Resuscitation
volume
179
pages
10 pages
publisher
Elsevier
external identifiers
  • pmid:35843406
  • scopus:85135846514
ISSN
0300-9572
DOI
10.1016/j.resuscitation.2022.07.013
language
English
LU publication?
yes
id
4050255d-a9cd-4ea4-93fd-71d82a617144
date added to LUP
2022-12-28 10:32:59
date last changed
2025-03-08 00:40:37
@article{4050255d-a9cd-4ea4-93fd-71d82a617144,
  abstract     = {{<p>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 (6 months (92% versus 75%, p-value &lt; 0.01), 3 years (74% vs 22%, p-value &lt; 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, p-value 0.52). The 121 non-frail patients reported better health compared to 27 frail patients (EQ-VAS median 70 versus 50 points, p-value &lt; 0.01) and less symptoms of depression than frail (16% and 52%, respectively, p-value &lt; 0.01). Conclusion: Frail patients suffering IHCA survived with the same neurological function they had at admittance. 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.</p>}},
  author       = {{Jonsson, Hanna and Piscator, Eva and Israelsson, Johan and Lilja, Gisela and Djärv, Therese}},
  issn         = {{0300-9572}},
  keywords     = {{CFS; Elderly; EQ-5D-5L; HADS; IHCA; Survival}},
  language     = {{eng}},
  pages        = {{233--242}},
  publisher    = {{Elsevier}},
  series       = {{Resuscitation}},
  title        = {{Is frailty associated with long-term survival, neurological function and patient-reported outcomes after in-hospital cardiac arrest? – A Swedish cohort study}},
  url          = {{http://dx.doi.org/10.1016/j.resuscitation.2022.07.013}},
  doi          = {{10.1016/j.resuscitation.2022.07.013}},
  volume       = {{179}},
  year         = {{2022}},
}