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A comparison of three quality-of-life measurement tools in out-of-hospital cardiac arrest survivors: A report from the Victorian Ambulance Cardiac Arrest Registry
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Abstracts / Resuscitation 96S (2015) 5–42
AS053
AS054
A comparison of three quality-of-life measurement tools in out-of-hospital cardiac arrest survivors: A report from the Victorian Ambulance Cardiac Arrest Registry
Characteristics and outcomes of out-of-hospital cardiac arrests (OHCA) in healthcare facilities – From The Pan Asian Resuscitation Outcomes Study (PAROS) Investigators
Emily Andrew 1,2,4,∗ , Ziad Nehme 1,2,4 , Marijana Lijovic 1,2,4 , Stephen Bernard 2,3,4 , Karen Smith 1,2,4
Yi-Ying Chen 1,∗ , Marcus E. Ong 2 , Sang Do Shin 3 , Hideharu Tanaka 4 , Tatsuya Nishiuchi 5 , Kyoung Jun Song 6 , Benjamin S. Leong 7 , Nalinas Khunkhlai 8 , Pairoj Khruekarnchana 9 , Gy Naroo 10 , Kantaro Kajino 11 , Yih Yng Ng 12 , Nik Hisamuddin 13 , Nausheen Edwin 2 , Apichaya Monsomboon 14 , Maeve Pin Pin Pek 2 , Wen-Chu Chiang 1 , Matthew Heui-Ming Ma 1 , Patrick Chow-In Ko 1 , PAROS Investigators
1
Ambulance Victoria, Melbourne, VIC, Australia Monash University, Melbourne, VIC, Australia 3 Alfred Hospital, Melbourne, VIC, Australia 4 University of Western Australia, Perth, WA, Australia 2
Introduction: Quality of life (QOL) research is relatively new in the field of out-of-hospital cardiac arrest (OHCA) and few healthrelated QOL (HRQOL) tools have been validated in this population. The Victorian Ambulance Cardiac Arrest Registry (VACAR) assesses the QOL and functional recovery of OHCA survivors’ 12-months post arrest. We sought to measure the correlation between instruments utilised, and assess their validity in the OHCA population. Methods: Telephone interviews were conducted with adult survivors who arrested between 1 January 2010 and 31 December 2013. Instruments included the Euro-QOL 5D (EQ-5D) and Visual Analogue Scale (VAS), Short Form 12 (SF-12), and Glasgow Outcome Scale–Extended (GOSE). The SF-6D score was also derived from patients’ SF-12 responses. Floor and ceiling effects of EQ-5D, SF-12 and SF-6D outcome scores were assessed. Spearman’s rho correlation coefficient was used to assess correlation between tools. Results: A total of 932 patients/proxies participated. No floor effects were observed, however a ceiling effect of 42.6% was observed for the EQ-5D summary score of patients, compared with 23.8% for proxies. The SF-6D correlated well with the EQ5D summary score (0.632, p < 0.01) and SF-12 Physical Component Summary (0.692, p < 0.01). However, the SF-12 Mental Component Summary correlated poorly with EQ-5D summary score and VAS (<0.300). For patients achieving a GOSE outcome ≥5, the distribution of SF-6D and EQ-5D summary scores were observed to differ significantly within each GOSE category (p < 0.001). Discussion: The EQ-5D index score yielded a large ceiling effect and thus performed poorly in the OHCA population. Varying correlation between instruments may be explained by differences in the content of instruments or the sensitivity of individual tools within this population. However further investigation is important to determine the appropriateness and validity of HRQOL and functional recovery tools in OHCA populations. http://dx.doi.org/10.1016/j.resuscitation.2015.09.065
1 Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan 2 Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore 3 Seoul National University, Seoul, Republic of Korea 4 Kokushikan University, Tokyo, Japan 5 Osaka City University Graduate School of Medicine, Osaka, Japan 6 Boramae Medical Center, Seoul, Republic of Korea 7 National University Hospital, Singapore, Singapore 8 Rajavithi Hospital, Bangkok, Thailand 9 Bangkok Hospital, Bangkok, Thailand 10 Department of Health and Medical Services, Government of Dubai, Dubai, United Arab Emirates 11 Osaka National Hospital, Osaka, Japan 12 Med Dept, Singapore Civil Defence Force, Singapore, Singapore 13 Universiti Sains Malaysia, School of Medical Sciences, Kelantan, Malaysia 14 Siriraj Hospital, Bangkok, Thailand
Aims: The PAROS Clinical Research Network (CRN) includes Japan, Singapore, South Korea, Malaysia, Taiwan, Thailand, and UAE-Dubai. In this study, we aim to report the characteristics and outcomes of out-of-hospital cardiac arrests (OHCA) patients located in healthcare facilities in PAROS. Methods: This is a prospective, international, multi-center cohort of OHCA across the Asia-Pacific, including patients from January 2009 to December 2012. A standardized taxonomy and case record form were used to collect common variables. Data were provided via an online electronic data capture (EDC) system or exported data from national registries. The patient/event characteristics and outcomes of OHCA located in healthcare facilities between PAROS countries were evaluated and compared. Results: A total of 28,529 non-traumatic OHCA cases with location information were included, of which 338 cases occurred at healthcare facilities (1.18%, 95% CI: 1.07–1.32%), incidence ranged from 0.4% (Japan, Taiwan) to 3.7% (Singapore) among sites. For OHCA at healthcare facilities (mean age 60, male 59%), 267/338 (79.0%, 95% CI: 74.3–83.0%, range: 57.1–100%) were witnessed collapse, 247/338 (73.1%, 95% CI: 68.1–77.5%, range: 36.4–100%) received bystander CPR, 86/338 (25.4%, 95% CI: 21.1–30.4%, range: 0–57.1%) presented with shockable rhythm upon EMS arrival. Only 12 cases (3.6%) received bystander defibrillation by healthcare facility staff. Survival to discharge was 15.7% (53/338) [95% CI: 12.2–19.9%] and the good neurological survival was 6.2% (21/338) [95% CI: 4.1–9.3%]. Compared with incidents at public sites, OHCA in healthcare facilities had better survival to discharge rate (odds ratio: 1.38 [95% 1.02–1.87]), but no benefit for good neurological outcome (0.9 [95% 0.6–1.4]).
Abstracts / Resuscitation 96S (2015) 5–42
AS053
AS054
A comparison of three quality-of-life measurement tools in out-of-hospital cardiac arrest survivors: A report from the Victorian Ambulance Cardiac Arrest Registry
Characteristics and outcomes of out-of-hospital cardiac arrests (OHCA) in healthcare facilities – From The Pan Asian Resuscitation Outcomes Study (PAROS) Investigators
Emily Andrew 1,2,4,∗ , Ziad Nehme 1,2,4 , Marijana Lijovic 1,2,4 , Stephen Bernard 2,3,4 , Karen Smith 1,2,4
Yi-Ying Chen 1,∗ , Marcus E. Ong 2 , Sang Do Shin 3 , Hideharu Tanaka 4 , Tatsuya Nishiuchi 5 , Kyoung Jun Song 6 , Benjamin S. Leong 7 , Nalinas Khunkhlai 8 , Pairoj Khruekarnchana 9 , Gy Naroo 10 , Kantaro Kajino 11 , Yih Yng Ng 12 , Nik Hisamuddin 13 , Nausheen Edwin 2 , Apichaya Monsomboon 14 , Maeve Pin Pin Pek 2 , Wen-Chu Chiang 1 , Matthew Heui-Ming Ma 1 , Patrick Chow-In Ko 1 , PAROS Investigators
1
Ambulance Victoria, Melbourne, VIC, Australia Monash University, Melbourne, VIC, Australia 3 Alfred Hospital, Melbourne, VIC, Australia 4 University of Western Australia, Perth, WA, Australia 2
Introduction: Quality of life (QOL) research is relatively new in the field of out-of-hospital cardiac arrest (OHCA) and few healthrelated QOL (HRQOL) tools have been validated in this population. The Victorian Ambulance Cardiac Arrest Registry (VACAR) assesses the QOL and functional recovery of OHCA survivors’ 12-months post arrest. We sought to measure the correlation between instruments utilised, and assess their validity in the OHCA population. Methods: Telephone interviews were conducted with adult survivors who arrested between 1 January 2010 and 31 December 2013. Instruments included the Euro-QOL 5D (EQ-5D) and Visual Analogue Scale (VAS), Short Form 12 (SF-12), and Glasgow Outcome Scale–Extended (GOSE). The SF-6D score was also derived from patients’ SF-12 responses. Floor and ceiling effects of EQ-5D, SF-12 and SF-6D outcome scores were assessed. Spearman’s rho correlation coefficient was used to assess correlation between tools. Results: A total of 932 patients/proxies participated. No floor effects were observed, however a ceiling effect of 42.6% was observed for the EQ-5D summary score of patients, compared with 23.8% for proxies. The SF-6D correlated well with the EQ5D summary score (0.632, p < 0.01) and SF-12 Physical Component Summary (0.692, p < 0.01). However, the SF-12 Mental Component Summary correlated poorly with EQ-5D summary score and VAS (<0.300). For patients achieving a GOSE outcome ≥5, the distribution of SF-6D and EQ-5D summary scores were observed to differ significantly within each GOSE category (p < 0.001). Discussion: The EQ-5D index score yielded a large ceiling effect and thus performed poorly in the OHCA population. Varying correlation between instruments may be explained by differences in the content of instruments or the sensitivity of individual tools within this population. However further investigation is important to determine the appropriateness and validity of HRQOL and functional recovery tools in OHCA populations. http://dx.doi.org/10.1016/j.resuscitation.2015.09.065
1 Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan 2 Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore 3 Seoul National University, Seoul, Republic of Korea 4 Kokushikan University, Tokyo, Japan 5 Osaka City University Graduate School of Medicine, Osaka, Japan 6 Boramae Medical Center, Seoul, Republic of Korea 7 National University Hospital, Singapore, Singapore 8 Rajavithi Hospital, Bangkok, Thailand 9 Bangkok Hospital, Bangkok, Thailand 10 Department of Health and Medical Services, Government of Dubai, Dubai, United Arab Emirates 11 Osaka National Hospital, Osaka, Japan 12 Med Dept, Singapore Civil Defence Force, Singapore, Singapore 13 Universiti Sains Malaysia, School of Medical Sciences, Kelantan, Malaysia 14 Siriraj Hospital, Bangkok, Thailand
Aims: The PAROS Clinical Research Network (CRN) includes Japan, Singapore, South Korea, Malaysia, Taiwan, Thailand, and UAE-Dubai. In this study, we aim to report the characteristics and outcomes of out-of-hospital cardiac arrests (OHCA) patients located in healthcare facilities in PAROS. Methods: This is a prospective, international, multi-center cohort of OHCA across the Asia-Pacific, including patients from January 2009 to December 2012. A standardized taxonomy and case record form were used to collect common variables. Data were provided via an online electronic data capture (EDC) system or exported data from national registries. The patient/event characteristics and outcomes of OHCA located in healthcare facilities between PAROS countries were evaluated and compared. Results: A total of 28,529 non-traumatic OHCA cases with location information were included, of which 338 cases occurred at healthcare facilities (1.18%, 95% CI: 1.07–1.32%), incidence ranged from 0.4% (Japan, Taiwan) to 3.7% (Singapore) among sites. For OHCA at healthcare facilities (mean age 60, male 59%), 267/338 (79.0%, 95% CI: 74.3–83.0%, range: 57.1–100%) were witnessed collapse, 247/338 (73.1%, 95% CI: 68.1–77.5%, range: 36.4–100%) received bystander CPR, 86/338 (25.4%, 95% CI: 21.1–30.4%, range: 0–57.1%) presented with shockable rhythm upon EMS arrival. Only 12 cases (3.6%) received bystander defibrillation by healthcare facility staff. Survival to discharge was 15.7% (53/338) [95% CI: 12.2–19.9%] and the good neurological survival was 6.2% (21/338) [95% CI: 4.1–9.3%]. Compared with incidents at public sites, OHCA in healthcare facilities had better survival to discharge rate (odds ratio: 1.38 [95% 1.02–1.87]), but no benefit for good neurological outcome (0.9 [95% 0.6–1.4]).