Number of hospital-free days: a clinically relevant patient-centered outcome in cardiac arrest patients.

Abstract

Patient centered-outcome should be considered in cardiac arrest patients but might be sometimes difficult to collect. The number of hospital-free days (HFD) has been reported strongly associated with neurological outcome in stroke patients and mid-term survival and quality of life in critically ill patients. Very few data has been reported about cardiac arrest (CA) patients so far. We used prospectively collected data from 2 French centers involved in the national network AfterRoSC. HFD at day-90 (HFD-d90) was calculated as the number of days alive and at home, excluding the index hospitalization. Correlation of HFD-d90 with the modified Rankin scale (mRs) was calculated as well as areas under the receiver- operator-curves (AUROC) of HFD-d90 versus binarized mRs. 253 patients were included with a day-90 mortality of 55 %. Modified Rankin scale was 6 [1-6]. Median HFD-d90 was 0 [0-68] days and mean HFD-d90 was 27 (sd 35) days. We observed a strong correlation between modified Rankin scale and HFD-d90. Area under the ROC was 0.92 [0.88; 0.96], 0.95 [0.92; 0.98], 0.96 [0.93; 0.99], 0.96 [0.93; 0.98] for the following comparisons mRs 0 vs. 1-6, 0-1 vs. 2-6, 0-2 vs. 3-6 and 0-3 vs. 4-6, respectively. HFD-d90 is a clinically relevant and potentially useful outcome to be used in future trials in CA patients.