Outcome predictors of patients with out of hospital cardiac arrest and immediate coronary angiography.
Adult
Age Factors
Aged
Cardiopulmonary Resuscitation
Coronary Angiography
Electric Countershock
Female
Hospital Mortality
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest
/ diagnostic imaging
Patient Admission
Predictive Value of Tests
Retrospective Studies
Return of Spontaneous Circulation
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
AMI-acute myocardial infarction
CAD-coronary artery disease
CS-cardiogenic shock
OHCA-out of hospital cardiac arrest
ROSC-return of spontaneous circulation
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
01 09 2020
01 09 2020
Historique:
received:
02
07
2019
revised:
24
09
2019
accepted:
26
10
2019
pubmed:
13
11
2019
medline:
7
4
2021
entrez:
13
11
2019
Statut:
ppublish
Résumé
Out of hospital cardiac arrest (OHCA) is common and associated with low survival rates. Guidelines propose a fast work-up after OHCA including coronary angiography (CA) but little is known about the actual outcome of those patients who undergo immediate CA after OHCA with suspected cardiac origin. The aim of this retrospective single-center study was to evaluate the short-term outcomes and predictors of in-hospital mortality in patients who underwent immediate CA after OHCA with suspected cardiac origin. We included all consecutive patients with OHCA who underwent immediate CA between January 2011 and December 2015. We defined immediate CA after OHCA as angiography within 2 hr after admission. Two hundred and nineteen consecutive patients with OHCA were included. Fifty six patients (26%) underwent CA without previous return of spontaneous circulation (ROSC) and with ongoing CPR using the LUCAS-device. One hundred and forty nine patients (67%) died in hospital. Of the 56 patients with CA with ongoing CPR, 55 died and only 1 patient survived to hospital discharge. In a multivariate analysis, older age (OR = 2.03, 95%CI 1.35-3.03; p = .001), initial shockable rhythm (OR = 0.28, 95%CI 0.07-1.13; p = .076), CA with ongoing CPR (OR = 11.63, 95%CI 1.20-122.55; p = .035), and initial arterial pH (OR = 0.008, 95%CI 0.00-0.228; p < .005) remained as independent predictors for in-hospital mortality. In this study older age, metabolic derangement on admission, initial nonshockable rhythm and failure to achieve ROSC before admission predicted in-hospital mortality. While CA with ongoing CPR with the LUCAS-device was feasible, mortality in patients without previous ROSC was extremely high, questioning whether this approach is medically useful.
Sections du résumé
BACKGROUND
Out of hospital cardiac arrest (OHCA) is common and associated with low survival rates. Guidelines propose a fast work-up after OHCA including coronary angiography (CA) but little is known about the actual outcome of those patients who undergo immediate CA after OHCA with suspected cardiac origin.
AIM
The aim of this retrospective single-center study was to evaluate the short-term outcomes and predictors of in-hospital mortality in patients who underwent immediate CA after OHCA with suspected cardiac origin.
METHODS
We included all consecutive patients with OHCA who underwent immediate CA between January 2011 and December 2015. We defined immediate CA after OHCA as angiography within 2 hr after admission.
RESULTS
Two hundred and nineteen consecutive patients with OHCA were included. Fifty six patients (26%) underwent CA without previous return of spontaneous circulation (ROSC) and with ongoing CPR using the LUCAS-device. One hundred and forty nine patients (67%) died in hospital. Of the 56 patients with CA with ongoing CPR, 55 died and only 1 patient survived to hospital discharge. In a multivariate analysis, older age (OR = 2.03, 95%CI 1.35-3.03; p = .001), initial shockable rhythm (OR = 0.28, 95%CI 0.07-1.13; p = .076), CA with ongoing CPR (OR = 11.63, 95%CI 1.20-122.55; p = .035), and initial arterial pH (OR = 0.008, 95%CI 0.00-0.228; p < .005) remained as independent predictors for in-hospital mortality.
CONCLUSIONS
In this study older age, metabolic derangement on admission, initial nonshockable rhythm and failure to achieve ROSC before admission predicted in-hospital mortality. While CA with ongoing CPR with the LUCAS-device was feasible, mortality in patients without previous ROSC was extremely high, questioning whether this approach is medically useful.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
509-516Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2019 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals, Inc.
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