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BMC Cardiovascular Disorders
Published in: BMC Cardiovascular Disorders 1/2007

Open Access 01-12-2007 | Study protocol

Activity and Life After Survival of a Cardiac Arrest (ALASCA) and the effectiveness of an early intervention service: design of a randomised controlled trial

Authors: Véronique RMP Moulaert, Jeanine A Verbunt, Caroline M van Heugten, Wilbert GM Bakx, Anton PM Gorgels, Sebastiaan CAM Bekkers, Marc CFTM de Krom, Derick T Wade

Published in: BMC Cardiovascular Disorders | Issue 1/2007

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Abstract

Background

Cardiac arrest survivors may experience hypoxic brain injury that results in cognitive impairments which frequently remain unrecognised. This may lead to limitations in daily activities and participation in society, a decreased quality of life for the patient, and a high strain for the caregiver. Publications about interventions directed at improving quality of life after survival of a cardiac arrest are scarce. Therefore, evidence about effective rehabilitation programmes for cardiac arrest survivors is urgently needed. This paper presents the design of the ALASCA (Activity and Life After Survival of a Cardiac Arrest) trial, a randomised, controlled clinical trial to evaluate the effects of a new early intervention service for survivors of a cardiac arrest and their caregivers.

Methods/design

The study population comprises all people who survive two weeks after a cardiac arrest and are admitted to one of the participating hospitals in the Southern part of the Netherlands. In a two-group randomised, controlled clinical trial, half of the participants will receive an early intervention service.
The early intervention service consists of several consultations with a specialised nurse for the patient and their caregiver during the first three months after the cardiac arrest. The intervention is directed at screening for cognitive problems, provision of informational, emotional and practical support, and stimulating self-management. If necessary, referral to specialised care can take place. Persons in the control group will receive the care as usual.
The primary outcome measures are the extent of participation in society and quality of life of the patient one year after a cardiac arrest. Secondary outcome measures are the level of cognitive, emotional and cardiovascular impairment and daily functioning of the patient, as well as the strain for and quality of life of the caregiver. Participants and their caregivers will be followed for twelve months after the cardiac arrest.
A process evaluation will be performed to gain insight into factors that might have contributed to the effectiveness of the intervention and to gather information about the feasibility of the programme. Furthermore, an economic evaluation will be carried out to determine the cost-effectiveness and cost-utility of the intervention.

Discussion

The results of this study will provide evidence on the effectiveness of this early intervention service, as well as the cost-effectiveness and its feasibility.

Trial registration

Current Controlled Trials [ISRCTN74835019]
Appendix
Available only for authorised users
Literature
1.
Myerburg RJ, Castellanos A: Cardiac arrest and sudden cardiac death. Heart Disease: A Textbook of Cardiovascular Medicine. Edited by: Braunwald E, Zipes DP and Libby P. 2001, Philadelphia, WB Saunders, 890-931. Sixth edition
2.
Waalewijn RA, de Vos R, Koster RW: Out-of-hospital cardiac arrests in Amsterdam and its surrounding areas: results from the Amsterdam resuscitation study (ARREST) in 'Utstein' style. Resuscitation. 1998, 38: 157-167. 10.1016/S0300-9572(98)00102-6.CrossRefPubMed
3.
Gorgels AP, Gijsbers C, de Vreede-Swagemakers J, Lousberg A, Wellens HJ: Out-of-hospital cardiac arrest--the relevance of heart failure. The Maastricht Circulatory Arrest Registry. Eur Heart J. 2003, 24: 1204-1209. 10.1016/S0195-668X(03)00191-X.CrossRefPubMed
4.
Berdowski RA, Waalewijn RA, Koster RW: Overleving na reanimatie buiten het ziekenhuis is sterk toegenomen: een vergelijkend onderzoek tussen eind 20ste en begin 21ste eeuw. Hart- en vaatziekten in Nederland najaar 2006, cijfers over ziekte en sterfte. Edited by: Vaartjes I, Peters RJG, van Dis SJ and Bots ML. 2006, Den Haag, Nederlandse Hartstichting
5.
Bottiger BW, Grabner C, Bauer H, Bode C, Weber T, Motsch J, Martin E: Long term outcome after out-of-hospital cardiac arrest with physician staffed emergency medical services: the Utstein style applied to a midsized urban/suburban area. Heart. 1999, 82: 674-679.CrossRefPubMedPubMedCentral
6.
7.
Fischer M, Fischer NJ, Schuttler J: One-year survival after out-of-hospital cardiac arrest in Bonn city: outcome report according to the 'Utstein style'. Resuscitation. 1997, 33: 233-243. 10.1016/S0300-9572(96)01022-2.CrossRefPubMed
8.
Hodgetts TJ, Kenward G, Vlackonikolis I, Payne S, Castle N, Crouch R, Ineson N, Shaikh L: Incidence, location and reasons for avoidable in-hospital cardiac arrest in a district general hospital. Resuscitation. 2002, 54: 115-123. 10.1016/S0300-9572(02)00098-9.CrossRefPubMed
9.
Huang CH, Chen WJ, Ma MH, Chang WT, Lai CL, Lee YT: Factors influencing the outcomes after in-hospital resuscitation in Taiwan. Resuscitation. 2002, 53: 265-270. 10.1016/S0300-9572(02)00024-2.CrossRefPubMed
10.
Patrick A, Rankin N: The in-hospital Utstein style: use in reporting outcome from cardiac arrest in Middlemore Hospital 1995-1996. Resuscitation. 1998, 36: 91-94. 10.1016/S0300-9572(98)00006-9.CrossRefPubMed
11.
Skogvoll E, Isern E, Sangolt GK, Gisvold SE: In-hospital cardiopulmonary resuscitation. 5 years' incidence and survival according to the Utstein template. Acta Anaesthesiol Scand. 1999, 43: 177-184. 10.1034/j.1399-6576.1999.430210.x.CrossRefPubMed
12.
Valenzuela TD, Roe DJ, Nichol G, Clark LL, Spaite DW, Hardman RG: Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. N Engl J Med. 2000, 343: 1206-1209. 10.1056/NEJM200010263431701.CrossRefPubMed
13.
Sauve MJ, Doolittle N, Walker JA, Paul SM, Scheinman MM: Factors associated with cognitive recovery after cardiopulmonary resuscitation. Am J Crit Care. 1996, 5: 127-139.PubMed
14.
Roine RO, Kajaste S, Kaste M: Neuropsychological sequelae of cardiac arrest. Jama. 1993, 269: 237-242. 10.1001/jama.269.2.237.CrossRefPubMed
15.
16.
Fertl E, Vass K, Sterz F, Gabriel H, Auff E: Neurological rehabilitation of severely disabled cardiac arrest survivors. Part I. Course of post-acute inpatient treatment. Resuscitation. 2000, 47: 231-239. 10.1016/S0300-9572(00)00239-2.CrossRefPubMed
17.
Lim C, Alexander MP, LaFleche G, Schnyer DM, Verfaellie M: The neurological and cognitive sequelae of cardiac arrest. Neurology. 2004, 63: 1774-1778.CrossRefPubMed
18.
Pusswald G, Fertl E, Faltl M, Auff E: Neurological rehabilitation of severely disabled cardiac arrest survivors. Part II. Life situation of patients and families after treatment. Resuscitation. 2000, 47: 241-248. 10.1016/S0300-9572(00)00240-9.CrossRefPubMed
19.
van Alem AP, de Vos R, Schmand B, Koster RW: Cognitive impairment in survivors of out-of-hospital cardiac arrest. Am Heart J. 2004, 148: 416-421. 10.1016/j.ahj.2004.01.031.CrossRefPubMed
20.
de Vos R, de Haes HC, Koster RW, de Haan RJ: Quality of survival after cardiopulmonary resuscitation. Arch Intern Med. 1999, 159: 249-254. 10.1001/archinte.159.3.249.CrossRefPubMed
21.
Lundgren-Nilsson A, Rosen H, Hofgren C, Sunnerhagen KS: The first year after successful cardiac resuscitation: function, activity, participation and quality of life. Resuscitation. 2005, 66: 285-289. 10.1016/j.resuscitation.2005.04.001.CrossRefPubMed
22.
Middelkamp W, Moulaert VR, Verbunt JA, van Heugten CM, Bakx WG, Wade DT: Life after survival: long-term daily life functioning and quality of life of patients with hypoxic brain injury as a result of a cardiac arrest. Clin Rehabil. 2007, 21: 425-431. 10.1177/0269215507075307.CrossRefPubMed
23.
Cowan MJ, Pike KC, Budzynski HK: Psychosocial nursing therapy following sudden cardiac arrest: impact on two-year survival. Nurs Res. 2001, 50: 68-76. 10.1097/00006199-200103000-00002.CrossRefPubMed
24.
Dougherty CM, Johnson-Crowley NR, Lewis FM, Thompson EA: Theoretical development of nursing interventions for sudden cardiac arrest survivors using social cognitive theory. ANS Adv Nurs Sci. 2001, 24: 78-86.CrossRefPubMed
25.
Dougherty CM, Lewis FM, Thompson EA, Baer JD, Kim W: Short-term efficacy of a telephone intervention by expert nurses after an implantable cardioverter defibrillator. Pacing Clin Electrophysiol. 2004, 27: 1594-1602. 10.1111/j.1540-8159.2004.00691.x.CrossRefPubMed
26.
Dougherty CM, Thompson EA, Lewis FM: Long-term outcomes of a telephone intervention after an ICD. Pacing Clin Electrophysiol. 2005, 28: 1157-1167. 10.1111/j.1540-8159.2005.09500.x.CrossRefPubMed
27.
Wade DT, King NS, Wenden FJ, Crawford S, Caldwell FE: Routine follow up after head injury: a second randomised controlled trial. J Neurol Neurosurg Psychiatry. 1998, 65: 177-183.CrossRefPubMedPubMedCentral
28.
Corrigan JD, Smith-Knapp K, Granger CV: Outcomes in the first 5 years after traumatic brain injury. Arch Phys Med Rehabil. 1998, 79: 298-305. 10.1016/S0003-9993(98)90010-7.CrossRefPubMed
29.
Sunnerhagen KS, Johansson O, Herlitz J, Grimby G: Life after cardiac arrest; a retrospective study. Resuscitation. 1996, 31: 135-140. 10.1016/0300-9572(95)00903-5.CrossRefPubMed
30.
Sander AM, Fuchs KL, High WM, Hall KM, Kreutzer JS, Rosenthal M: The Community Integration Questionnaire revisited: an assessment of factor structure and validity. Arch Phys Med Rehabil. 1999, 80: 1303-1308. 10.1016/S0003-9993(99)90034-5.CrossRefPubMed
31.
Cardol M, Beelen A, van den Bos GA, de Jong BA, de Groot IJ, de Haan RJ: Responsiveness of the Impact on Participation and Autonomy questionnaire. Arch Phys Med Rehabil. 2002, 83: 1524-1529. 10.1053/apmr.2002.35099.CrossRefPubMed
32.
Hoeymans N, van Lindert H, Westert GP: The health status of the Dutch population as assessed by the EQ-6D. Qual Life Res. 2005, 14: 655-663. 10.1007/s11136-004-1214-z.CrossRefPubMed
33.
Aaronson NK, Muller M, Cohen PD, Essink-Bot ML, Fekkes M, Sanderman R, Sprangers MA, te Velde A, Verrips E: Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol. 1998, 51: 1055-1068. 10.1016/S0895-4356(98)00097-3.CrossRefPubMed
34.
von Steinbuechel N, Petersen C, Bullinger M: Assessment of health-related quality of life in persons after traumatic brain injury--development of the Qolibri, a specific measure. Acta Neurochir Suppl. 2005, 93: 43-49.CrossRefPubMed
35.
Broadbent DE, Cooper PF, FitzGerald P, Parkes KR: The Cognitive Failures Questionnaire (CFQ) and its correlates. Br J Clin Psychol. 1982, 21 (Pt 1): 1-16.CrossRef
36.
Alderson AL, Novack TA: Reliable serial measurement of cognitive processes in rehabilitation: the Cognitive Log. Arch Phys Med Rehabil. 2003, 84: 668-672.CrossRefPubMed
37.
Vlaar AM, Wade DT: The Adult Memory and Information Processing Battery (AMIPB) test of information-processing speed: a study of its reliability and feasibility in patients with multiple sclerosis. Clin Rehabil. 2003, 17: 386-393. 10.1191/0269215503cr625oa.CrossRefPubMed
38.
Sunderland A, Watts K, Baddeley AD, Harris JE: Subjective memory assessment and test performance in elderly adults. J Gerontol. 1986, 41: 376-384.CrossRefPubMed
39.
O'Donnell WE, Reynolds DM, De Soto CB: Neuropsychological impairment scale (NIS): initial validation study using trailmaking test (A & B) and WAIS digit symbol (scaled score) in a mixed grouping of psychiatric, neurological, and normal patients. J Clin Psychol. 1983, 39: 746-748. 10.1002/1097-4679(198309)39:5<746::AID-JCLP2270390517>3.0.CO;2-7.CrossRefPubMed
40.
Vlaar AM, Wade DT: Verbal fluency assessment of patients with multiple sclerosis: test-retest and inter-observer reliability. Clin Rehabil. 2003, 17: 756-764. 10.1191/0269215503cr674oa.CrossRefPubMed
41.
Spinhoven P, Ormel J, Sloekers PP, Kempen GI, Speckens AE, Van Hemert AM: A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med. 1997, 27: 363-370. 10.1017/S0033291796004382.CrossRefPubMed
42.
Sundin EC, Horowitz MJ: Impact of Event Scale: psychometric properties. Br J Psychiatry. 2002, 180: 205-209. 10.1192/bjp.180.3.205.CrossRefPubMed
43.
van der Ploeg E, Mooren TT, Kleber RJ, van der Velden PG, Brom D: Construct validation of the Dutch version of the impact of event scale. Psychol Assess. 2004, 16: 16-26. 10.1037/1040-3590.16.1.16.CrossRefPubMed
44.
Bennett JA, Riegel B, Bittner V, Nichols J: Validity and reliability of the NYHA classes for measuring research outcomes in patients with cardiac disease. Heart Lung. 2002, 31: 262-270. 10.1067/mhl.2002.124554.CrossRefPubMed
45.
Kleinman L, Zodet MW, Hakim Z, Aledort J, Barker C, Chan K, Krupp L, Revicki D: Psychometric evaluation of the fatigue severity scale for use in chronic hepatitis C. Qual Life Res. 2000, 9: 499-508. 10.1023/A:1008960710415.CrossRefPubMed
46.
de Haan R, Limburg M, Schuling J, Broeshart J, Jonkers L, van Zuylen P: [Clinimetric evaluation of the Barthel Index, a measure of limitations in dailly activities]. Ned Tijdschr Geneeskd. 1993, 137: 917-921.PubMed
47.
Turnbull JC, Kersten P, Habib M, McLellan L, Mullee MA, George S: Validation of the Frenchay Activities Index in a general population aged 16 years and older. Arch Phys Med Rehabil. 2000, 81: 1034-1038. 10.1053/apmr.2000.7162.CrossRefPubMed
48.
Thornton M, Travis SS: Analysis of the reliability of the modified caregiver strain index. J Gerontol B Psychol Sci Soc Sci. 2003, 58: S127-32.CrossRefPubMed
49.
Goossens ME, Rutten-van Molken MP, Vlaeyen JW, van der Linden SM: The cost diary: a method to measure direct and indirect costs in cost-effectiveness research. J Clin Epidemiol. 2000, 53: 688-695. 10.1016/S0895-4356(99)00177-8.CrossRefPubMed
50.
Oostenbrink JB, Bouwmans CAM, Koopmanschap MA, Rutten FFH: Handleiding voor Kostenonderzoek: Methoden en standaard kostprijzen voor economische evaluaties in de gezondheidszorg. 2004, , College voor zorgverzekeringen, Geactualiseerde versie
51.
Ustun TB, Chatterji S, Bickenbach J, Kostanjsek N, Schneider M: The International Classification of Functioning, Disability and Health: a new tool for understanding disability and health. Disabil Rehabil. 2003, 25: 565-571. 10.1080/0963828031000137063.CrossRefPubMed
Metadata
Title
Activity and Life After Survival of a Cardiac Arrest (ALASCA) and the effectiveness of an early intervention service: design of a randomised controlled trial
Authors
Véronique RMP Moulaert
Jeanine A Verbunt
Caroline M van Heugten
Wilbert GM Bakx
Anton PM Gorgels
Sebastiaan CAM Bekkers
Marc CFTM de Krom
Derick T Wade
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2007
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/1471-2261-7-26

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