Kristian Kragholm1, Mads Wissenberg2, Rikke Normark Mortensen2, Kirsten Fonager2, Svend Eggert Jensen2, Shahzleen Rajan2, Freddy Knudsen Lippert2, Erika Frischknecht Christensen2, Poul Anders Hansen2, Torsten Lang-Jensen2, Ole Mazur Hendriksen2, Lars Kober2, Gunnar Gislason2, Christian Torp-Pedersen2, Bodil Steen Rasmussen2. 1. From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.). kdks@rn.dk. 2. From Department of Anesthesiology and Intensive Care Medicine, Cardiovascular Research Center (K.K., B.S.R.), and Departments of Social Medicine (K.F.) and Cardiology (S.E.J.), Aalborg University Hospital, Denmark; Clinical Institute of Medicine, Aarhus University, Aalborg, Denmark (K.K., E.F.C., B.S.R.); Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark (M.W., S.R., G.G.); Department of Health, Science, and Technology, Aalborg University, Denmark (R.N.M., K.F., S.E.J., C.T-P.); Prehospital Emergency Medical Services, Regions of Denmark: The Capital (F.K.L.), Zealand (O.M.H.), South Denmark (T.L.-J.), Central (E.F.C.), and North Denmark (P.A.H.); Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Denmark (L.K.); National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark (G.G.); and Danish Heart Foundation, Copenhagen, Denmark (G.G.).
Abstract
BACKGROUND: Data on long-term function of out-of-hospital cardiac arrest survivors are sparse. We examined return to work as a proxy of preserved function without major neurologic deficits in survivors. METHODS AND RESULTS: In Denmark, out-of-hospital cardiac arrests have been systematically reported to the Danish Cardiac Arrest Register since 2001. During 2001-2011, we identified 4354 patients employed before arrest among 12 332 working-age patients (18-65 years), of whom 796 survived to day 30. Among 796 survivors (median age, 53 years [quartile 1-3, 46-59 years]; 81.5% men), 610 (76.6%) returned to work in a median time of 4 months [quartile 1-3, 1-19 months], with a median time of 3 years spent back at work. A total of 74.6% (N=455) remained employed without using sick leave during the first 6 months after returning to work. This latter proportion of survivors returning to work increased over time (66.1% in 2001-2005 versus 78.1% in 2006-2011; P=0.002). In multivariable Cox regression analysis, factors associated with return to work with ≥6 months of sustainable employment were as follows: (1) arrest during 2006-2011 versus 2001-2005, hazard ratio (HR), 1.38 (95% CI, 1.05-1.82); (2) male sex, HR, 1.48 (95% CI, 1.06-2.07); (3) age of 18 to 49 versus 50 to 65 years, HR, 1.32 (95% CI, 1.02-1.68); (4) bystander-witnessed arrest, HR, 1.79 (95% CI, 1.17-2.76); and (5) bystander cardiopulmonary resuscitation, HR, 1.38 (95% CI, 1.02-1.87). CONCLUSIONS: Of 30-day survivors employed before arrest, 76.6% returned to work. The percentage of survivors returning to work increased significantly, along with improved survival during 2001-2011, suggesting an increase in the proportion of survivors with preserved function over time.
BACKGROUND: Data on long-term function of out-of-hospital cardiac arrest survivors are sparse. We examined return to work as a proxy of preserved function without major neurologic deficits in survivors. METHODS AND RESULTS: In Denmark, out-of-hospital cardiac arrests have been systematically reported to the Danish Cardiac Arrest Register since 2001. During 2001-2011, we identified 4354 patients employed before arrest among 12 332 working-age patients (18-65 years), of whom 796 survived to day 30. Among 796 survivors (median age, 53 years [quartile 1-3, 46-59 years]; 81.5% men), 610 (76.6%) returned to work in a median time of 4 months [quartile 1-3, 1-19 months], with a median time of 3 years spent back at work. A total of 74.6% (N=455) remained employed without using sick leave during the first 6 months after returning to work. This latter proportion of survivors returning to work increased over time (66.1% in 2001-2005 versus 78.1% in 2006-2011; P=0.002). In multivariable Cox regression analysis, factors associated with return to work with ≥6 months of sustainable employment were as follows: (1) arrest during 2006-2011 versus 2001-2005, hazard ratio (HR), 1.38 (95% CI, 1.05-1.82); (2) male sex, HR, 1.48 (95% CI, 1.06-2.07); (3) age of 18 to 49 versus 50 to 65 years, HR, 1.32 (95% CI, 1.02-1.68); (4) bystander-witnessed arrest, HR, 1.79 (95% CI, 1.17-2.76); and (5) bystander cardiopulmonary resuscitation, HR, 1.38 (95% CI, 1.02-1.87). CONCLUSIONS: Of 30-day survivors employed before arrest, 76.6% returned to work. The percentage of survivors returning to work increased significantly, along with improved survival during 2001-2011, suggesting an increase in the proportion of survivors with preserved function over time.
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