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Out of hospital cardiac arrest: long-term outcomes according to status at hospital arrival

K.B. Sondergaard, S. Riddersholm, M. Wissenberg, S.M. Hansen, T.A. Gerds, C. Barcello, et al., European Heart Journal ( 2018 ) 39 ( Supplement ), 60

Background: The association between pre-hospital factors and outcomes in out of hospital cardiac arrest is well documented. However, evidence pertaining to the association between the patient's status at hospital arrival

and long-term outcomes remains scarce.

Aim: To examine long-term outcomes relative to consciousness status at hospital arrival in out of hospital cardiac arrest patients.

Methods: All cardiac arrests cases ≥18 years of age were identified from the nationwide Danish Cardiac Arrest Registry from 2005 through 2014. Patients declared dead at hospital arrival were excluded. Thirty day survival was evaluated by cumulative incidences according to the Kaplan Meier estimator. Anoxic brain damage or nursing home admission among 30day survivors and return to work among working age 30day survivors were evaluated by cause specific cumulative incidences.

Results: A total of 13,951 cardiac arrest patients were included: 844 (6.0%) patients had return of spontaneous circulation (ROSC) and were conscious, 5,117 (36.7%) patients had ROSC, but were comatose, and 7,990 (57.3%) patients had ongoing resuscitation at hospital arrival. Altogether 2,815 patients survived 30 days after cardiac arrest. The cumulative incidence rates of 30day survival according to status at hospital arrival (conscious, comatose, and ongoing resuscitation) were 89.3% (95% confidence interval [CI] 87.3%91.4%), 38.4% (95% CI 37.0%39.7%), and 1.2% (95% CI 0.9%1.5%), respectively. Among 30day survivors, the 1year cumulative incidence rates of anoxic brain damage or nursing home admission were 2.1% (95% CI 1.0%3.1%), 13.3% (95% CI 11.7%14.8%), and 19.8% (95% CI 11.8%27.8%). Altogether, of 1,627 patients in working age (18–65 years of age), 894 survived 30 days and 748 of those (83.7%) returned to work within the 5year follow-up period. The cumulative incidence rates of return to work were: 92.9% (95% CI 89.6%96.3%), 81.7% (95% CI 78.6–84.7), and 68.5% (95% CI 53.2%83.8%) for patients' conscious, comatose and with ongoing resuscitation.

Conclusions: Nearly all out of hospital cardiac arrest patients conscious, two fifths of patients comatose, and very few patients with ongoing resuscitation at hospital arrival survived the first 30 days following arrest. Nonetheless, among 30day survivors the minority had anoxic brain damage or were admitted to a nursing home and the majority returned to work in all three groups

Source: ESC 2018 Last Modified :Oct 17, 2019.
Compiled and edited by the Editorial team and approved by Expert panel of CardioValens.com
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