Predictors for outcome among cardiac arrest patients: the importance of initial cardiac arrest rhythm versus time to return of spontaneous circulation, a retrospective cohort study

BMC Emergency Medicine

Research Article

Kristine Norsted¹  Henrik Schmidt¹  Ida Wibrandt¹  Jens Schierbeck¹ 

[1] Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark;

关键词: Cardiac Arrest;    Neurological Outcome;    Therapeutic Hypothermia;    Cerebral Performance Category;    Cardiac Arrest Patient;   

DOI  :  10.1186/s12873-015-0028-3

 received in 2013-10-25, accepted in 2015-01-26,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundIn the past decade, early treatment of cardiac arrest (CA) victims has been improved in several ways, leading to more optimistic over all prognoses. However, the global survival rate after out-of-hospital CA (OHCA) is still not more than 5-10%. With a better knowledge of the predictors for outcome among CA patients, we can improve the management of CA, in order to strengthen the leads in the chain of survival.MethodsA retrospective cohort study including 172 CA patients admitted to the intensive care unit (ICU) in Odense University Hospital (OUH) in a three-year period was conducted. We determined the 90-day mortality and neurological outcome at discharge for CA patients treated with therapeutic hypothermia (TH), in regard to determine the importance of the predictors for mortality and neurological outcome, with emphasize on combining initial rhythm and time to return of spontaneous circulation (ROSC).ResultsThe overall mortality was 44% and a favorable neurological outcome was seen among 52%. Strong predictors for survival and favorable neurological outcome were ventricular tachycardia/ventricular fibrillation (VT/VF) as initial rhythm, cardiac etiology and time to ROSC < 20 minutes. Age < 60 years was a predictor for survival only. Patients with the combination of VT/VF and ROSC < 20 minutes had undeniably the best chance of both survival and a favorable neurological outcome.ConclusionsWe found significant predictors for both survival and neurological outcome, in which an initial rhythm of VT/VF and a cardiac etiology were the strongest.

【 授权许可】

CC BY   
© Wibrandt et al.; licensee BioMed Central. 2015