scholarly journals Intraosseous access in out-of-hospital cardiac arrest: No difference in terms of mid-term survival and neurological outcome in a national registry

Resuscitation ◽  
2019 ◽  
Vol 142 ◽  
pp. e37
Author(s):  
Joséphine Escutnaire ◽  
Sophie Nave ◽  
Valentine Baert ◽  
Christian Vilhelm ◽  
Karim Tazarourte ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Neurological Outcome ◽  
National Registry ◽  
Intraosseous Access ◽  
Term Survival ◽  
Hospital Cardiac Arrest

Abstract 44: Time to Epinephrine Impacts Mortality Following Pediatric In-Hospital Nonshockable Cardiac Arrest

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Lars W Andersen ◽  
Katherine Berg ◽  
Brian Z Saindon ◽  
Joseph M Massaro ◽  
Tia T Raymond ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Discharge ◽  
Neurological Outcome ◽  
Spontaneous Circulation ◽  
National Registry ◽  
Epinephrine Administration ◽  
Negatively Associated ◽  
Logistic Regression Models ◽  
Shockable Rhythm ◽  
Hospital Cardiac Arrest

Background: Delay in administration of the first epinephrine dose has been shown to be associated with a lower chance of good outcome in adult, in-hospital, non-shockable cardiac arrest. Whether this association is true in pediatric in-hospital non-shockable cardiac arrest remains unknown. Methods: We utilized the Get With the Guidelines - Resuscitation national registry to identify pediatric patients (age < 18 years) with an in-hospital cardiac arrest between 2000 and 2010. We included patients with an initial non-shockable rhythm who received at least one dose of epinephrine. To assess the association between time to epinephrine administration and survival to discharge we used multivariate logistic regression models with adjustment for multiple predetermined variables including age, gender, illness category, pre-existing mechanical ventilation, monitored, witnessed, location, time of the day/week, year of arrest, insertion of an airway, initial rhythm, time to initiation of cardiopulmonary resuscitation, hospital type and hospital teaching status. Secondary outcomes included return of spontaneous circulation (ROSC) and neurological outcome. Results: 1,131 patients were included. Median age was 9 months (quartiles: 21 days - 6 years) and 46% were female. Overall survival to hospital discharge was 29%. Longer time to epinephrine was negatively associated with survival to discharge in multivariate analysis (OR: 0.94 [95%CI: 0.90 - 0.98], per minute delay). Longer time to epinephrine was negatively associated with ROSC (OR: 0.93 [95%CI: 0.90 - 0.97], per minute delay) but was not statistically significantly associated with survival with good neurological outcome (OR: 0.95 [95%CI: 0.89 - 1.03], per minute delay). Conclusions: Delay in administration of epinephrine during pediatric in-hospital cardiac arrest with a non-shockable rhythm is associated with a lower chance of ROSC and lower survival to hospital discharge.

Abstract 305: German Resuscitation Registry Influence of Age on Short and Long-Term Outcome After Out-of-Hospital Cardiac Arrest or Should We Resuscitate the Elderly?

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Stephan Seewald ◽  
Jan Wnent ◽  
Barbara Jakisch ◽  
Andreas Bohn ◽  
Matthias Fischer ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Neurological Outcome ◽  
The Elderly ◽  
Good Neurological Outcome ◽  
Term Survival ◽  
Long Term Survival ◽  
Shockable Rhythm ◽  
Short And Long Term ◽  
Hospital Cardiac Arrest

Introduction: Cardiac arrest is a common event and one of the leading causes of death. Especially within the elderly judgment on if the treatment will be in favor of the patient is a major challenge for the medical team. We evaluated the influence of the age on short and long-term survival after out-of- hospital cardiac arrest (OHCA). Hypothesis: Elderly people survive an out-of-hospital cardiac arrest with good neurological outcome. Methods: For this purpose, we analyzed data of 24,686 out-of-hospital cardiac arrest patients prospectively registered between 2008 and 2017 within the German Resuscitation Registry (GRR). The data records were divided according to different age groups and within the age group after shockable and non-shockable rhythms. The data sets were examined with regard to short and long-term survival. Short term survival was measured by expected and observed return-of-spontaneous circulation based on the RACA-score. The RACA-score is a previously published score to predict ROSC based on readily available variables after arrival of the emergency medical service (EMS) on scene. Long-term survival was differentiated in 24-hour survival, 30-day survival and hospital discharge with good neurological outcome (Cerebral Performance Category 1 and 2). Results: (Table 1) Conclusions: Our data shows that shockable rhythm and younger age are important factors of good neurological outcome after OHCA. Nevertheless, the few cases with shockable rhythms (411 out of 3227) in the elderly (>85 years) showed a favorable neurological outcome in 12.2% (77,2% of all patients with hospital discharge). In the non-shockable group 1.4% (58,3%) of the >85 year old had a good outcome. Data show that a resuscitation attempt in the elderly is not futile, especially if a shockable rhythm is detected. Further studies are necessary to maintain this decision.

scholarly journals Early Coronary Angiography Is Associated with Improved 30-Day Outcomes among Patients with out-of-Hospital Cardiac Arrest

2021 ◽  
Vol 10 (21) ◽  
pp. 5191
Author(s):  
Shir Lynn Lim ◽  
Yee How Lau ◽  
Mark Y. Chan ◽  
Terrance Chua ◽  
Huay Cheem Tan ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Coronary Angiography ◽  
Neurological Outcome ◽  
National Registry ◽  
Inverse Probability ◽  
Weighted Estimates ◽  
Cardiac Procedures ◽  
Outcomes Study ◽  
Inverse Probability Weighted ◽  
Hospital Cardiac Arrest

We evaluated the association between early coronary angiography (CAG) and outcomes in resuscitated out-of-hospital cardiac arrest (OHCA) patients, by linking data from the Singapore Pan-Asian Resuscitation Outcomes Study, with a national registry of cardiac procedures. The 30-day survival and neurological outcome were compared between patients undergoing early CAG (within 1-calender day), versus patients not undergoing early CAG. Inverse probability weighted estimates (IPWE) adjusted for non-randomized CAG. Of 976 resuscitated OHCA patients of cardiac etiology between 2011–2015 (mean(SD) age 64(13) years, 73.7% males), 337 (34.5%) underwent early CAG, of whom, 230 (68.2%) underwent PCI. Those who underwent early CAG were significantly younger (60(12) vs. 66(14) years old), healthier (42% vs. 59% with heart disease; 29% vs. 44% with diabetes), more likely males (86% vs. 67%), and presented with shockable rhythms (69% vs. 36%), compared with those who did not. Early CAG with PCI was associated with better survival and neurological outcome (adjusted odds ratio 1.91 and 1.82 respectively), findings robust to IPWE adjustment. The rates of bleeding and stroke were similar. CAG with PCI within 24 h was associated with improved clinical outcomes after OHCA, without increasing complications. Further studies are required to identify the characteristics of patients who would benefit most from this invasive strategy.

scholarly journals In-hospital Cardiac Arrest in Patients With Heart Failure: Long- and Short-term Survival and Trends

2021 ◽  
Author(s):  
Emma Aune ◽  
John McMurray ◽  
Peter Lundgren ◽  
Naveed Sattar ◽  
Johan Israelsson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Arrest ◽  
Neurological Outcome ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Term Survival ◽  
Ventricular Ejection Fraction ◽  
Patients With Heart Failure ◽  
Hospital Cardiac Arrest ◽  
Short Term Survival

Abstract In patients with heart failure (HF) who suffered in-hospital cardiac arrest (IHCA), little is known about the characteristics, survival and neurological outcome. We used the Swedish Registry of Cardiopulmonary Resuscitation to study this, including patients aged ≥18 years suffering IHCA (2008-2019), categorised as HF alone, HF with acute myocardial infarction (AMI), AMI alone, or other. Odds ratios (OR) for 30-day survival, trends in 30-day survival, and the implication of HF phenotype was studied. 6378 patients had HF alone, 2111 had HF with AMI, 4210 had AMI alone. Crude 5-year survival was 9.6% for HF alone, 12.9% for HF with AMI and 34.6% for AMI alone. The 5-year survival was 7.9% for patients with HF and left ventricular ejection fraction (LVEF) ≥50%, 15.4% for LVEF <40% and 12.3% for LVEF 40-49%. Compared with AMI alone, adjusted OR (95% CI) for 30-day survival was 0.66 (0.60-0.74) for HF alone, and 0.49 (0.43-0.57) for HF with AMI. OR for 30-day survival in 2017-2019 compared with 2008-2010 were 1.55 (1.24-1.93) for AMI alone, 1.37 (1.00-1.87) for HF with AMI and 1.30 (1.07-1.58) for HF alone. Survivors with HF had good neurological outcome in 92% of cases.

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