Early ADL ability assessment and cognitive screening as markers of post-discharge outcomes after surviving an out-of-hospital cardiac arrest. A prospective cohort study

TY - JOUR

T1 - Early ADL ability assessment and cognitive screening as markers of post-discharge outcomes after surviving an out-of-hospital cardiac arrest. A prospective cohort study

AU - Kristensen, Lola Qvist

AU - Eiskjær, Hans

AU - van Tulder, Maurits

AU - Ejlersen Wæhrens, Eva Elisabet

AU - Sørensen, Lotte

AU - Bro-Jeppesen, John

AU - Eastwood, Glenn

AU - Oestergaard, Lisa Gregersen

N1 - Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.

PY - 2025/5/21

Y1 - 2025/5/21

N2 - Background Assessment of activities of daily living (ADL) and cognitive screening are widely used in the care of out-of-hospital cardiac arrest (OHCA) survivors. Evidence linking them to post-discharge outcomes is limited, but could support targeted rehabilitation efforts. Aim To assess whether ADL ability measures and cognitive screening at hospital discharge were associated with post-discharge ADL ability, health-related quality of life (HRQoL) and return to work. Methods This prospective cohort study included 200 OHCA survivors admitted to Aarhus University Hospital. Self-reported ADL ability was measured using the Activities of Daily Living Interview (ADL-I). Observed ADL ability was measured with the Assessment of Motor and Process Skills (AMPS), dichotomised into age-matched or below-ability. Cognitive function was assessed with Montreal Cognitive Assessment (MoCA). Multivariable regressions, with multiple imputation, analysed associations between variables and outcomes, adjusting for age, sex, and comorbidities. Results Adjusted analyses showed significant associations between personal ADL-I (βadjusted=0.3, 95%CI: 0.2;0.5) and AMPS (βadjusted=-0.6, 95%CI:-1.2;-0.03) at discharge and self-reported ADL ability six months after cardiac arrest. Baseline AMPS was statistically significantly associated with age-matched ADL ability six months after cardiac arrest (ORadjusted 5.5, 95%CI: 1.5;10.0), and personal ADL-I (VAS: βadjusted= 3.00, 95%CI: 1.3;4.6/index score: βadjusted=0.03, 95%CI 0.01;0.05) and MoCA (index: βadjusted=-0.09, 95%CI: -0.2;-0.02) with HRQoL. The association between MoCA and return to work one-year after cardiac arrest showed an OR of 3.0 (95%CI: 0.5;9.0), although not statistically significant (p=0.06). Conclusions Decreased ADL ability at hospital discharge was associated with poorer post-discharge outcomes in OHCA survivors, while cognitive screening was also associated with certain aspects of recovery.

AB - Background Assessment of activities of daily living (ADL) and cognitive screening are widely used in the care of out-of-hospital cardiac arrest (OHCA) survivors. Evidence linking them to post-discharge outcomes is limited, but could support targeted rehabilitation efforts. Aim To assess whether ADL ability measures and cognitive screening at hospital discharge were associated with post-discharge ADL ability, health-related quality of life (HRQoL) and return to work. Methods This prospective cohort study included 200 OHCA survivors admitted to Aarhus University Hospital. Self-reported ADL ability was measured using the Activities of Daily Living Interview (ADL-I). Observed ADL ability was measured with the Assessment of Motor and Process Skills (AMPS), dichotomised into age-matched or below-ability. Cognitive function was assessed with Montreal Cognitive Assessment (MoCA). Multivariable regressions, with multiple imputation, analysed associations between variables and outcomes, adjusting for age, sex, and comorbidities. Results Adjusted analyses showed significant associations between personal ADL-I (βadjusted=0.3, 95%CI: 0.2;0.5) and AMPS (βadjusted=-0.6, 95%CI:-1.2;-0.03) at discharge and self-reported ADL ability six months after cardiac arrest. Baseline AMPS was statistically significantly associated with age-matched ADL ability six months after cardiac arrest (ORadjusted 5.5, 95%CI: 1.5;10.0), and personal ADL-I (VAS: βadjusted= 3.00, 95%CI: 1.3;4.6/index score: βadjusted=0.03, 95%CI 0.01;0.05) and MoCA (index: βadjusted=-0.09, 95%CI: -0.2;-0.02) with HRQoL. The association between MoCA and return to work one-year after cardiac arrest showed an OR of 3.0 (95%CI: 0.5;9.0), although not statistically significant (p=0.06). Conclusions Decreased ADL ability at hospital discharge was associated with poorer post-discharge outcomes in OHCA survivors, while cognitive screening was also associated with certain aspects of recovery.

KW - Activities of daily living

KW - Cognition

KW - Health-related quality of life

KW - Out-of-hospital cardiac arrest

KW - Return to work

UR - http://www.scopus.com/inward/record.url?scp=105006724983&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2025.110653

DO - 10.1016/j.resuscitation.2025.110653

M3 - Journal article

C2 - 40409672

SN - 0300-9572

JO - Resuscitation

JF - Resuscitation

M1 - 110653

ER -