Quality-of-life and formal functional testing of survivors of out-of-hospital cardiac arrest correlates poorly with traditional neurologic outcome scales

Annals of Emergency Medicine
J W HsuM L Callaham

Abstract

The traditional (and unvalidated) five-point Cerebral Performance Category (CPC) score at hospital discharge does not correlate with the results yielded by a validated functional status instrument and subjective quality-of-life assessment. We compared CPC scores with the results of prospective standardized testing after discharge in survivors of out-of-hospital cardiac arrest. Consenting survivors were tested with the validated Functional Status Questionnaire (FSQ), a subjective quality-of-life assessment, and traditional CPC scoring. Of the 3,130 arrests during the 52 months of the study, 93 patients survived. Thirty-five patients were tested (71% of those eligible at the time of follow-up). Of these patients, 34% said their quality of life was worse, 38% said it was the same, and 28% said it was better than before the cardiac arrest. Fifty-four percent of patients scored normally on all FSQ subscales, but the remainder had an average 2.1 areas (of 6) with significant impairment. CPC score correlated very poorly with quality-of-life rating and with all scores and subscores on the FSQ. A CPC of 1 on discharge (supposedly normal function) had a sensitivity of 78%, a specificity of 43%, a positive predictive value of 64%, and a n...Continue Reading

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Citations

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