Cardiac Arrest Survivorship Research Hub

Out-of-hospital cardiac arrest (OHCA) occurs when the heart pauses to function outside of a medical facility. The high mortality rate persists despite advancements in resuscitation research, rendering it a significant global public health issue. To substantially reduce mortality associated with OHCA, a comprehensive understanding of all management phases—pre-hospital, in-hospital, and post-discharge—is essential. Pre-hospital factors, such as community socioeconomic level, bystander cardiopulmonary resuscitation (CPR), and access to defibrillators, are essential for early survival. In-hospital variables, like the accessibility of round-the-clock cardiac interventional treatments and structured emergency reception systems, can affect outcomes. Post-discharge survival mostly depends on patient adherence to medical and lifestyle interventions, psychological support, and rehabilitation programs. This assessment consolidates information about the factors influencing the management of OHCA and identifies critical issues and opportunities within the Jordanian healthcare system.

This psychometric study aimed to evaluate the psychometric properties of the Dysexecutive Questionnaire (DEX) following a cardiac event, and to examine the relationship between self- and informant-ratings. Approximately 7 months post-cardiac event, 196 participants and their informants ( = 179) completed the DEX. Reliability was assessed by confirmatory factor analysis and internal consistency estimates. Construct validity was evaluated using two performance-based neuropsychological tests, the Colour-Word Interference Test and the Trail Making Test (TMT), along with the Hospital Anxiety and Depression Scale (HADS). A one-factor model showed acceptable fit for the self-assessed DEX (RMSEA = 0.062) with excellent internal consistency ( > 0.90). Slight positive associations were found between the DEX and the performance-based executive function measures, while strong positive associations emerged between the self-assessed DEX and the HADS. Overall, self-assessed and informant-reported scores did not differ significantly (self-assessed DEX median = 11,- = 5.75-20; informant-reported DEX median = 11,- = 4-19, = 0.924). However, participants with severe executive dysfunction (TMT-B-scores ≤-2) rated their own symptoms as less severe than informants ( = .001), indicating impaired self-awareness in a subgroup of participants. In conclusion, the DEX provides a useful perspective into general executive dysfunction in daily life but should be complemented with performance-based measures.ClinicalTrials.gov identifier: NCT03543371.

AIM: To investigate potential in-hospital cognitive and psychopathological factors associated with fatigue three months after out-of-hospital cardiac arrest (OHCA). METHODS: This was a multicenter prospective cohort study conducted across three heart centers in Denmark. While in-hospital, OHCA survivors were screened for cognitive impairment using the Montreal Cognitive Assessment, self-reported symptoms of anxiety and depression using the Hospital Anxiety and Depression Scale, and traumatic distress using the Impact of Event Scale - Revised. At three-month follow-up, fatigue severity was assessed with the Fatigue Severity Scale (FSS). FSS ≥ 4 indicates clinically important fatigue. Logistic regression models were applied. RESULTS: Overall, 173 survivors were included (mean age 63.1 ± 11.7 years). At follow-up, the median FSS score was 3.2 points (IQR 2-9) and 42 % of survivors presented with clinically important fatigue (FSS ≥ 4). Those with fatigue were more often female, had longer hospital stays, reported greater in-hospital symptoms of anxiety, depression and traumatic distress, poorer sleep quality and health-related quality of life at follow-up. In the multivariable regression model, including age, sex, length of stay, anxiety, depression, traumatic distress and sleep quality, only traumatic distress was independently associated with FSS ≥ 4 (OR 4.6, 95 % CI: 1.5-14.7, p = 0.009). CONCLUSION: More than a third of OHCA survivors self-reported fatigue at three-month follow-up. In-hospital symptoms of traumatic distress were associated with higher odds of fatigue. While these findings underscore the potential value of early identification of traumatic distress, further research is needed to evaluate the benefits of screening and to identify interventions to support recovery after cardiac arrest.