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Return to Work and Participation in Society after Out-of-Hospital Cardiac Arrest

Lilja, Gisela LU ; Nielsen, Niklas LU ; Bro-Jeppesen, John ; Dunford, Hannah ; Friberg, Hans LU ; Hofgren, Caisa LU ; Horn, Janneke ; Insorsi, Angelo ; Kjaergaard, Jesper and Nilsson, Fredrik LU , et al. (2018) In Circulation: Cardiovascular Quality and Outcomes 11(1). p.1-11
Abstract

Background: The aim of this study was to describe out-of-hospital cardiac arrest (OHCA) survivors' ability to participate in activities of everyday life and society, including return to work. The specific aim was to evaluate potential effects of cognitive impairment. Methods and Results: Two hundred eighty-seven OHCA survivors included in the TTM trial (Target Temperature Management) and 119 matched control patients with ST-segment-elevation myocardial infarction participated in a follow-up 180 days post-event that included assessments of participation, return to work, emotional problems, and cognitive impairment. On the Mayo-Portland Adaptability Inventory-4 Participation Index, OHCA survivors (n=270) reported more restricted... (More)

Background: The aim of this study was to describe out-of-hospital cardiac arrest (OHCA) survivors' ability to participate in activities of everyday life and society, including return to work. The specific aim was to evaluate potential effects of cognitive impairment. Methods and Results: Two hundred eighty-seven OHCA survivors included in the TTM trial (Target Temperature Management) and 119 matched control patients with ST-segment-elevation myocardial infarction participated in a follow-up 180 days post-event that included assessments of participation, return to work, emotional problems, and cognitive impairment. On the Mayo-Portland Adaptability Inventory-4 Participation Index, OHCA survivors (n=270) reported more restricted participation In everyday life and in society (47% versus 30%; P<0.001) compared with ST-segment-elevation myocardial infarction controls (n=118). Furthermore, 27% (n=36) of pre-event working OHCA survivors (n=135) compared with 7% (n=3) of pre-event working ST-segment-elevation myocardial infarction controls (n=45) were on sick leave (odds ratio, 4.9; 95% confidence interval, 1.4-16.8; P=0.01). Among the OHCA survivors assumed to return to work (n=135), those with cognitive impairment (n=55) were 3× more likely (odds ratio, 3.3; 95% confidence interval, 1.2-9.3; P=0.02) to be on sick leave compared with those without cognitive impairment (n=40; 36%, n=20, versus 15%, n=6). For OHCA survivors, the variables that were found most predictive for a lower participation were depression, restricted mobility, memory impairment, novel problem-solving difficulties, fatigue, and slower processing speed. Conclusions: OHCA survivors reported a more restricted societal participation 6 months post-arrest, and their return to work was lower compared with ST-segment-elevation myocardial infarction controls. Cognitive impairment was significantly associated with lower participation, together with the closely related symptoms of fatigue, depression, and restricted mobility. These predictive variables may be used during follow-up to identify OHCA survivors at risk of a less successful recovery that may benefit from further support and rehabilitation. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01946932.

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Contribution to journal
publication status
published
subject
keywords
cognitive dysfunction, depression, fatigue, heart arrest, sick leave, temperature
in
Circulation: Cardiovascular Quality and Outcomes
volume
11
issue
1
article number
e003566
pages
1 - 11
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:29326145
  • scopus:85044142238
ISSN
1941-7713
DOI
10.1161/CIRCOUTCOMES.117.003566
language
English
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yes
id
f702229a-744a-453a-8c8d-a2e2ed4de633
date added to LUP
2019-06-29 22:55:46
date last changed
2020-07-08 04:58:12
@article{f702229a-744a-453a-8c8d-a2e2ed4de633,
  abstract     = {<p>Background: The aim of this study was to describe out-of-hospital cardiac arrest (OHCA) survivors' ability to participate in activities of everyday life and society, including return to work. The specific aim was to evaluate potential effects of cognitive impairment. Methods and Results: Two hundred eighty-seven OHCA survivors included in the TTM trial (Target Temperature Management) and 119 matched control patients with ST-segment-elevation myocardial infarction participated in a follow-up 180 days post-event that included assessments of participation, return to work, emotional problems, and cognitive impairment. On the Mayo-Portland Adaptability Inventory-4 Participation Index, OHCA survivors (n=270) reported more restricted participation In everyday life and in society (47% versus 30%; P&lt;0.001) compared with ST-segment-elevation myocardial infarction controls (n=118). Furthermore, 27% (n=36) of pre-event working OHCA survivors (n=135) compared with 7% (n=3) of pre-event working ST-segment-elevation myocardial infarction controls (n=45) were on sick leave (odds ratio, 4.9; 95% confidence interval, 1.4-16.8; P=0.01). Among the OHCA survivors assumed to return to work (n=135), those with cognitive impairment (n=55) were 3× more likely (odds ratio, 3.3; 95% confidence interval, 1.2-9.3; P=0.02) to be on sick leave compared with those without cognitive impairment (n=40; 36%, n=20, versus 15%, n=6). For OHCA survivors, the variables that were found most predictive for a lower participation were depression, restricted mobility, memory impairment, novel problem-solving difficulties, fatigue, and slower processing speed. Conclusions: OHCA survivors reported a more restricted societal participation 6 months post-arrest, and their return to work was lower compared with ST-segment-elevation myocardial infarction controls. Cognitive impairment was significantly associated with lower participation, together with the closely related symptoms of fatigue, depression, and restricted mobility. These predictive variables may be used during follow-up to identify OHCA survivors at risk of a less successful recovery that may benefit from further support and rehabilitation. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01946932.</p>},
  author       = {Lilja, Gisela and Nielsen, Niklas and Bro-Jeppesen, John and Dunford, Hannah and Friberg, Hans and Hofgren, Caisa and Horn, Janneke and Insorsi, Angelo and Kjaergaard, Jesper and Nilsson, Fredrik and Pelosi, Paolo and Winters, Tineke and Wise, Matt P. and Cronberg, Tobias},
  issn         = {1941-7713},
  language     = {eng},
  month        = {01},
  number       = {1},
  pages        = {1--11},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Circulation: Cardiovascular Quality and Outcomes},
  title        = {Return to Work and Participation in Society after Out-of-Hospital Cardiac Arrest},
  url          = {http://dx.doi.org/10.1161/CIRCOUTCOMES.117.003566},
  doi          = {10.1161/CIRCOUTCOMES.117.003566},
  volume       = {11},
  year         = {2018},
}