Objective:

To examine the association between health-related quality of life (HRQOL) measured 3 to 6 months after in-hospital cardiac arrest (IHCA) or out-of-hospital cardiac arrest (OHCA) and long-term survival, highlighting differences between the two populations.

Key Findings:

• Among 2,000 IHCA survivors, those with the poorest HRQOL had over twice the risk of mortality compared to those with no problems.
• No significant mortality association was found for categorical HRQOL scores among 1,108 OHCA survivors; however, continuous measures indicated increased mortality risk with poorer health.
• Depressive symptoms were linked to reduced long-term survival in IHCA survivors.

Interpretation:

Poorer HRQOL shortly after cardiac arrest is associated with lower long-term survival, particularly in IHCA survivors, suggesting the potential for HRQOL assessments to inform follow-up care.

Limitations:

• High rates of missing HRQOL data (nearly 50% for IHCA and over 60% for OHCA) raise concerns about selection bias.
• The observational design limits causal inference and may not capture cardiac arrest-specific sequelae.
• HRQOL was assessed at a single time point, which may not reflect changes in recovery.

Conclusion:

This study highlights the importance of HRQOL assessments in predicting long-term survival outcomes in cardiac arrest survivors, suggesting that these assessments could inform follow-up care strategies.