| Title | Prognostic Association Between Frailty and Post-Arrest Health Outcomes in Patients Receiving Home Care: A Population-Based Retrospective Cohort Study |
| Publication Type | Journal Article |
| Year of Publication | 2023 |
| Authors | Mowbray FI, Turcotte L, Strum RP, de Wit K, Griffith LE, Worster A, Foroutan F, Heckman G, Hébert P, Schumacher C, Jones A, Mercier E, Gayowsky A, Costa AP |
| Journal | Resuscitation |
| Volume | 187 |
| Pagination | 109766 |
| Date Published | 2023/06/01 |
| ISBN Number | 0300-9572 |
| Accession Number | 36931455 |
| Keywords | Advance Care Planning, Cardiac arrest, Frailty, home care |
| Abstract | Aim To evaluate the association between frailty and post-cardiac arrest survival, functional decline, and cognitive decline, among patients receiving home care. Methods Frailty was measured using the Clinical Frailty Scale (CFS) and a valid frailty index. We used multivariable logistic regression to measure the association between frailty and post-arrest outcomes after adjusting for age, sex, and arrest setting. Functional independence and cognitive performance were measured using the interRAI ADL Long-Form and Cognitive Performance Scale, respectively. We conducted sub-group analytics of in-hospital and out-of-hospital arrests. Results Our cohort consisted of 7,901 home care clients; most patients arrested out-of-hospital (55.4%) and were 75 years or older (66.3%). Most were classified as frail (94.2%) with a CFS score of 5 or greater. The 30-day survival rate was higher for in-hospital (26.6%) than out-of-hospital cardiac arrests (5.2%). Most patients who survived to discharge had declines in post-arrest functional independence (65.8%) and cognitive performance (46.5%). A one-point increase in the CFS decreased the odds of 30-day survival by 8% (aOR = 0.92; 95%CI = 0.87–0.97). A 0.1 unit increase in the frailty index reduced the odds of 30-day survival by 9% (aOR = 0.91; 95%CI = 0.86–0.96). The frailty index was associated with declines in functional independence (OR = 1.16; 95%CI = 1.02–1.31) and cognitive performance (OR = 1.24; 95%CI = 1.09–1.42), while the CFS was not. Conclusion Frailty is associated with cardiac arrest survival and post-arrest cognitive and functional status in patients receiving home care. Post-cardiac arrest cognitive and functional status are best predicted using more comprehensive frailty indices. |
| DOI | 10.1016/j.resuscitation.2023.109766 |
| Link | https://www.sciencedirect.com/science/article/pii/S0300957223000795 |
