Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Sten Rubertsson, Uppsala University, Sweden
- Second opponent: Professor Pål Klepstad, Norwegian University of Science and Technology, Trondheim
- Third member and chair of the evaluation committee: Professor II Ida Gjervold Lunde, University of Oslo
Chair of the Defence
Professor II Ole Henning Skjønsberg, University of Oslo
Principal Supervisor
Espen Rostrup Nakstad, Oslo University Hospital
Summary
Hypoxic brain injury is a feared complication after cardiac arrest often leading to treatment withdrawal in particularly serious cases. Reliable prognostic tools are important to reveal hypoxic brain injury accurately at an early stage, but are not sufficiently investigated in patients with non-shockable rhythms.
More than 80% of out-of-hospital cardiac arrest patients discharged from hospital are alive 5 years after their arrest. Nevertheless, our knowledge of their quality of life in the upcoming years after their arrest is limited.
This thesis aimed to compare the accuracy of the recommended prognostic tools in cardiac arrest patients with shockable versus non-shockable rhythms. The thesis further assessed quality of life, health status, anxiety and depression in cardiac arrest survivors 6 months and 5 years post-arrest by means of the following questionnaires; Short-form 36, Hospital Anxiety and Depression scale and EuroQoL-5D-3L.
The 5-year follow-up data were compared to data at 6 months and to an age- and sex-matched Norwegian reference population. In addition, health status was retrospectively assessed for each of the first 5 years post-arrest.
The prognostic tools, in particular pupillary light reflex, brain CT, EEG and SSEP, and neuron-specific enolase predicted brain injury equally well in both rhythm groups.
Overall, quality of life was good and comparable to the reference population at 5 years. While older survivors reported good and stable quality of life over time, younger survivors (<58 y) stated a reduced mental quality of life and more anxiety symptoms at both time points.
Although they improved over time, they still scored lower than older survivors at 5 years. They also reported a lower health status during the first 3 years (50/100 vs. 88/100), before it increased to 5 years (76/100 vs. 89/100).
In summary, quality of life 5 years after cardiac arrest was good, but was lower among younger survivors both 6 months and 5 years after cardiac arrest.
Additional information
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