Incidence and factors associated with out-of-hospital peri-intubation cardiac arrest: a secondary analysis of the CURASMUR trial

Abstract Background Mechanical circulatory support (MCS) with either extracorporeal membrane oxygenation or Impella has shown potential as a salvage therapy for patients with refractory out-of-hospital cardiac arrest (OHCA). The objective of this study was to describe the gradual implementation, survival and adherence to the national consensus with respect to use of MCS for OHCA in Denmark, and to identify factors associated with outcome. Methods This retrospective, observational cohort study included patients receiving MCS for OHCA at all tertiary cardiac arrest centers (n = 4) in Denmark between July 2011 and December 2020. Logistic regression and Kaplan–Meier survival analysis were used to determine association with outcome. Outcome was presented as survival to hospital discharge with good neurological outcome, 30-day survival and predictors of 30-day mortality. Results A total of 259 patients were included in the study. Thirty-day survival was 26%. Sixty-five (25%) survived to hospital discharge and a good neurological outcome (Glasgow–Pittsburgh Cerebral Performance Categories 1–2) was observed in 94% of these patients. Strict adherence to the national consensus showed a 30-day survival rate of 30% compared with 22% in patients violating one or more criteria. Adding criteria to the national consensus such as signs of life during cardiopulmonary resuscitation (CPR), pre-hospital low-flow < 100 min, pH > 6.8 and lactate < 15 mmol/L increased the survival rate to 48%, but would exclude 58% of the survivors from the current cohort. Logistic regression identified asystole (RR 1.36, 95% CI 1.18–1.57), pulseless electrical activity (RR 1.20, 95% CI 1.03–1.41), initial pH < 6.8 (RR 1.28, 95% CI 1.12–1.46) and lactate levels > 15 mmol/L (RR 1.16, 95% CI 1.16–1.53) as factors associated with increased risk of 30-day mortality. Patients presenting signs of life during CPR had reduced risk of 30-day mortality (RR 0.63, 95% CI 0.52–0.76). Conclusions A high survival rate with a good neurological outcome was observed in this Danish population of patients treated with MCS for OHCA. Stringent patient selection for MCS may produce higher survival rates but potentially withholds life-saving treatment in a significant proportion of survivors.

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Risk factors associated with adverse fetal outcomes in pregnancies affected by Coronavirus disease 2019 (COVID-19): a secondary analysis of the WAPM study on COVID-19

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0539 ◽

2021 ◽

Vol 49 (1) ◽

pp. 111-115

Author(s):

Daniele Di Mascio ◽

Cihat Sen ◽

Gabriele Saccone ◽

Alberto Galindo ◽

Amos Grünebaum ◽

...

Keyword(s):

Risk Factors ◽

Secondary Analysis ◽

Fetal Outcomes ◽

Factors Associated

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Impella CP Implantation during Cardiopulmonary Resuscitation for Cardiac Arrest: A Multicenter Experience

Journal of Clinical Medicine ◽

10.3390/jcm10020339 ◽

2021 ◽

Vol 10 (2) ◽

pp. 339

Author(s):

Vassili Panagides ◽

Henrik Vase ◽

Sachin P. Shah ◽

Mir B. Basir ◽

Julien Mancini ◽

...

Keyword(s):

Cardiac Arrest ◽

Survival Rate ◽

Cardiopulmonary Resuscitation ◽

Univariate Analysis ◽

Cerebral Performance Category ◽

Neurological Impairment ◽

Left Ventricular ◽

Circulatory Support ◽

Factors Associated ◽

Analysis Survival

Background: Impella CP is a left ventricular pump which may serve as a circulatory support during cardiopulmonary resuscitation (CPR) for cardiac arrest (CA). Nevertheless, the survival rate and factors associated with survival in patients undergoing Impella insertion during CPR for CA are unknown. Methods: We performed a retrospective multicenter international registry of patients undergoing Impella insertion during on-going CPR for in- or out-of-hospital CA. We recorded immediate and 30-day survival with and without neurologic impairment using the cerebral performance category score and evaluated the factors associated with survival. Results: Thirty-five patients had an Impella CP implanted during CPR for CA. Refractory ventricular arrhythmias were the most frequent initial rhythm (65.7%). In total, 65.7% of patients immediately survived. At 30 days, 45.7% of patients were still alive. The 30-day survival rate without neurological impairment was 37.1%. In univariate analysis, survival was associated with both an age < 75 years and a time from arrest to CPR ≤ 5 min (p = 0.035 and p = 0.008, respectively). Conclusions: In our multicenter registry, Impella CP insertion during ongoing CPR for CA was associated with a 37.1% rate of 30-day survival without neurological impairment. The factors associated with survival were a young age and a time from arrest to CPR ≤ 5 min.

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Surviving traumatic cardiac arrest: Identification of factors associated with survival

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2021.01.020 ◽

2021 ◽

Vol 43 ◽

pp. 83-87

Author(s):

Andrew Khalifa ◽

Jacob B. Avraham ◽

Kristina Z. Kramer ◽

Francesco Bajani ◽

Chih Yuan Fu ◽

...

Keyword(s):

Cardiac Arrest ◽

Factors Associated ◽

Traumatic Cardiac Arrest

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Modifiable risk factors associated with sudden cardiac arrest within hemodialysis clinics

Kidney International ◽

10.1038/ki.2010.315 ◽

2011 ◽

Vol 79 (2) ◽

pp. 218-227 ◽

Cited By ~ 154

Author(s):

Patrick H. Pun ◽

Ruediger W. Lehrich ◽

Emily F. Honeycutt ◽

Charles A. Herzog ◽

John P. Middleton

Keyword(s):

Risk Factors ◽

Cardiac Arrest ◽

Sudden Cardiac Arrest ◽

Modifiable Risk Factors ◽

Factors Associated

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Emergency department factors associated with survival after sudden cardiac arrest

Resuscitation ◽

10.1016/j.resuscitation.2012.10.013 ◽

2013 ◽

Vol 84 (3) ◽

pp. 292-297 ◽

Cited By ~ 35

Author(s):

Nicholas J. Johnson ◽

Rama A. Salhi ◽

Benjamin S. Abella ◽

Robert W. Neumar ◽

David F. Gaieski ◽

...

Keyword(s):

Emergency Department ◽

Cardiac Arrest ◽

Sudden Cardiac Arrest ◽

Factors Associated

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Survival and Factors Associated with Survival with Extracorporeal Life Support During Cardiac Arrest

ASAIO Journal ◽

10.1097/mat.0000000000001613 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Vassili Panagides ◽

Marc Laine ◽

Guillaume Fond ◽

Guillaume Lebreton ◽

Franck Paganelli ◽

...

Keyword(s):

Cardiac Arrest ◽

Life Support ◽

Extracorporeal Life Support ◽

Factors Associated

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Factors Associated with Intermittent, Constant, and Mixed Pain in People with Knee Osteoarthritis

Physiotherapy Canada ◽

10.3138/ptc-2020-0093 ◽

2021 ◽

Author(s):

Fatme Hoteit ◽

Debbie Erhmann Feldman ◽

Lisa C. Carlesso

Keyword(s):

Knee Osteoarthritis ◽

Physical Function ◽

Multinomial Logistic Regression ◽

Secondary Analysis ◽

Cross Sectional ◽

System Sensitivity ◽

Factors Associated ◽

Lower Likelihood ◽

Paindetect Questionnaire ◽

Mixed Pain

Purpose: To explore factors associated with intermittent, constant, and mixed pain in people with knee osteoarthritis. Method: We conducted a secondary analysis of a cross-sectional multicenter study with adults ≥ 40 years with knee osteoarthritis. Participants completed questionnaires on personal (e.g., demographics, comorbidities), physical (e.g., physical function), psychological (e.g., depressive symptoms), pain (e.g., qualities), and tests for physical performance and nervous system sensitivity. We qualified patients’ pain as intermittent, constant, or mixed using the Modified painDETECT Questionnaire and assessed associations with the variables using multinomial logistic regression. Results: The 279 participants had an average age of 63.8 years (SD = 9.6), BMI of 31.5 kg/m2 (SD = 8.7), and 58.6% were female. Older age (odds ratio [OR] 0.95; 95% CI: 0.90, 1.00) and higher self-reported physical function ([OR] 0.94; 95% CI: 0.91, 0.98) were associated with a lower likelihood of mixed pain compared with intermittent pain. Higher pain intensity ([OR] 1.25; 95% CI: 1.07, 1.47) was related to a 25% higher likelihood of mixed pain compared with intermittent pain. Conclusions: This study provides initial data for associations of personal, pain, and physical function factors with different pain patterns. Awareness of these factors can help clinicians develop targeted strategies for managing patients’ pain.

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