Long-term Survival After Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-analysis.
Journal
JAMA cardiology
ISSN: 2380-6591
Titre abrégé: JAMA Cardiol
Pays: United States
ID NLM: 101676033
Informations de publication
Date de publication:
01 06 2022
01 06 2022
Historique:
pubmed:
5
5
2022
medline:
11
6
2022
entrez:
4
5
2022
Statut:
ppublish
Résumé
Data on long-term survival beyond 12 months after out-of-hospital cardiac arrest (OHCA) of a presumed cardiac cause are scarce. To investigate the long-term survival of adult patients after surviving the initial hospital stay for an OHCA. A systematic search of the EMBASE and MEDLINE databases was performed from database inception to March 25, 2021. Clinical studies reporting long-term survival after OHCA were selected based on predefined inclusion and exclusion criteria according to a preregistered study protocol. Patient data were reconstructed from Kaplan-Meier curves using an iterative algorithm and then pooled to generate survival curves. As a separate analysis, an aggregate data meta-analysis was performed. The primary outcome was long-term survival (>12 months) after OHCA for patients surviving to hospital discharge or 30 days after OHCA. The search identified 15 347 reports, of which 21 studies (11 800 patients) were included in the Kaplan-Meier-based meta-analysis and 33 studies (16 933 patients) in an aggregate data meta-analysis. In the Kaplan-Meier-based analysis, the median survival time for patients surviving to hospital discharge was 5.0 years (IQR, 2.3-7.9 years). The estimated survival rates were 82.8% (95% CI, 81.9%-83.7%) at 3 years, 77.0% (95% CI, 75.9%-78.0%) at 5 years, 63.9% (95% CI, 62.3%-65.4%) at 10 years, and 57.5% (95% CI, 54.8%-60.1%) at 15 years. Compared with patients with a nonshockable initial rhythm, patients with a shockable rhythm had a lower risk of long-term mortality (hazard ratio, 0.30; 95% CI, 0.23-0.39; P < .001). Different analyses, including an aggregate data meta-analysis, confirmed these results. In this comprehensive systematic review and meta-analysis, long-term survival after 10 years in patients surviving the initial hospital stay after OHCA was between 62% and 64%. Additional research is needed to understand and improve the long-term survival in this vulnerable patient population.
Identifiants
pubmed: 35507352
pii: 2791886
doi: 10.1001/jamacardio.2022.0795
pmc: PMC9069345
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
633-643Commentaires et corrections
Type : CommentIn
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