Cardiac Arrest Survivorship Research Hub

A robust chain of survival is important for achieving positive outcomes following out-of-hospital cardiac arrest, which continues to pose a substantial public health challenge in Singapore. Although improvements have been made in prehospital resuscitation and survival to hospital admission, further progress is required for survival to hospital discharge and neurological recovery. This underscores the urgent need to strengthen post-cardiac arrest care-the sixth link in the chain of survival-to optimise outcomes for patients admitted to the intensive care unit after return of spontaneous circulation. This review builds on earlier recommendations of the National Targeted Temperature Management Workgroup (2017) and the National Post-Cardiac Arrest and Survivorship Workgroup (2021), providing an updated summary of post-cardiac arrest management and practical guidance for clinicians treating resuscitated cardiac arrest patients in the intensive care unit.

OBJECTIVES: To (1) identify cardiac arrest (CA) survivors' and their caregivers' stressors and coping and compensation strategies related to brain health and (2) gather feedback on a proposed brain health lifestyle intervention for this population. METHODS: We conducted two focus groups with dyads of CA survivors and their caregivers ( = 9 dyads) and ten interviews ( = 10 dyads), recruited from the Sudden Cardiac Arrest Foundation's Cardiac Arrest Survivor Alliance, BuildClinical, and provider referrals between 9/2024 and 5/2025. We purposefully sampled to include populations at-risk for cognitive decline based on race and ethnicity. We conducted rapid qualitative data analysis of our focus groups and interview transcripts. RESULTS: Dyads described several sources of brain health stress including survivors' cognitive changes, fear of further decline, and concerns about caregiver stress. Dyads reported using coping strategies including peer support, professional mental health treatment, acceptance strategies, and physical activity, and compensation strategies including delegating more tasks to the caregiver, using organizational aids, visual aids, and pacing strategies. Dyads endorsed proposed program content and recommended additional content on nutrition and diet, managing emotional distress, and psychoeducation on the impact of CA on the brain. CONCLUSION: Survivors and caregivers experience ongoing stressors related to brain health, though they develop coping and compensation strategies that merit further study.

AIMS: To describe the proportion and severity of fatigue among out-of-hospital cardiac arrest (OHCA) survivors and to investigate the association between age group (working-age 18-64 years vs ≥65 years) and fatigue. METHODS AND RESULTS: This cross-sectional study used data from the Danish Cardiac Survivorship (DANCAS) survey, including adult (≥18 years) OHCA survivors. Fatigue (the Modified Fatigue Impact Scale, MFIS), anxiety and depression (Hospital Anxiety and Depression Scale, HADS), and disability (WHO Disability Assessment Schedule, WHODAS 2.0) were assessed. Descriptive statistics characterised fatigue across age groups. Linear regression models (unadjusted and adjusted) investigated the association between age group and fatigue, reported as regression coefficients (β) and 95% confidence intervals (CI).In total, n = 1236 survivors (median age 67 years, IQR 57-74) were included, of whom 551 were of working age and 685 were ≥65 years. Working-age survivors reported significantly higher (worse) levels of fatigue (median 19, IQR 6-38) compared to those aged ≥65 years (median 13, IQR 5-28). Working age was significantly associated with higher fatigue scores after adjustment for sex and age (β 4.80, 95% CI 2.63-6.98). The association was reduced but remained statistically significant after further adjusting for anxiety, depression, and disability (β 1.57, 95% CI 0.22-2.92). CONCLUSION: Working-age OHCA survivors reported higher levels of fatigue compared with survivors aged ≥65 years, particularly in the non-physical domains. The association was reduced after adjustment, suggesting overlap between fatigue, psychological distress and disability. These findings highlight the need for multidimensional and age-specific assessment of post-OHCA fatigue.