Abstract 226: Sex Differences in Cardiac Catheterization Following Out-of-Hospital Cardiac Arrest

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Bryn E Mumma ◽  
James F Holmes ◽  
Machelle D Wilson ◽  
Deborah B Diercks
Keyword(s):  
Cardiac Arrest ◽  
Sex Differences ◽  
Cardiac Catheterization ◽  
Health Planning ◽  
Acute Care Hospital ◽  
Coronary Intervention ◽  
Admission Diagnosis ◽  
Care Hospital ◽  
Hospital Data ◽  
Hospital Cardiac Arrest

Introduction: Cardiac catheterization is recommended for patients resuscitated from out-of-hospital cardiac arrest (OHCA) with a suspected cardiac etiology. Women are less likely than men to receive cardiac catheterization in other presentations of cardiovascular disease, but it remains unknown whether this disparity extends to OHCA. Objective: To determine whether patient sex is associated with undergoing cardiac catheterization after OHCA. Methods: We included all adult cases in the 2011 California Office of Statewide Health Planning and Development (OSHPD) database with a present-on-admission diagnosis of cardiac arrest (ICD-9-CM 427.5) or sudden cardiac death (ICD-9-CM 798) who were admitted from the emergency department to an acute care hospital. Data extracted from the OSHPD database included patient demographics, diagnoses, and procedures. ICD-9-CM procedure codes from the OSHPD database were used to identify patients who received cardiac catheterization. To determine factors associated with undergoing cardiac catheterization, we used a hierarchical logistic regression model that included age, sex, race, ethnicity, insurance type, ventricular arrest rhythm, and treatment at a hospital with 24/7 percutaneous coronary intervention capability. Results: We studied 4493 men and 3287 women admitted following OHCA. Women were older (median age 70 vs 64 years; p<0.001), had had fewer ventricular arrest rhythms (21.8% vs 31.7%; p<0.001), and received fewer cardiac catheterization procedures [12.5% vs 21.4%; p<0.0001]. This sex difference in cardiac catheterization persisted in the multivariable hierarchical model (adjusted OR 0.65; 95% CI 0.57-0.76; p<0.0001) and in a subgroup analysis including only patients with ventricular arrest rhythms (adjusted OR 0.63; 95% CI 0.51-0.78; p<0.0001) Conclusion: Sex differences exist in cardiac catheterization following resuscitation from OHCA. Future efforts should focus on understanding and resolving these differences.

scholarly journals Cerebellar Haemorrhage Leading to Sudden Cardiac Arrest

2020 ◽  
Vol 6 (1) ◽  
pp. 71-73 ◽  
Author(s):  
Ankit Agrawal ◽  
Maria Cardinale ◽  
Douglas Frenia ◽  
Aveek Mukherjee
Keyword(s):  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Acute Care Hospital ◽  
Pulseless Electrical Activity ◽  
Cerebrovascular Event ◽  
Care Hospital ◽  
Cerebellar Haemorrhage ◽  
Shockable Rhythm ◽  
Cardiac Stunning ◽  
Hospital Cardiac Arrest

AbstractIntroductionIntracranial haemorrhage (ICH) is a known, but a rare cause of out of hospital cardiac arrest (OHCA). It results in the development of non-shockable rhythms such as asystole or pulseless electrical activity (PEA).Case ReportA 77- years old male had an OHCA without any prodrome. An emergency medical services (EMS) team responded to an emergency call and intubated the patient at the site before transporting him to the Acute Care Hospital, New Brunswick, New Jersey, USA. On admission, a non-contrast computed tomography scan of the head revealed a large cerebellar haemorrhage. Non-traumatic ICH is a rare cause of OHCA. Although subarachnoid haemorrhage causing cardiac arrest has been described in the literature, cerebellar haemorrhage leading to cardiac arrest is rare. The mechanism by which ICH patients develop cardiac arrest is likely explained by a massive catecholamine surge leading to cardiac stunning.ConclusionA non-shockable rhythm in the seting of a sudden cardiac arrest should raise alarms for a primary non-cardiac ethology, especially a primary cerebrovascular event. The absence of brainstem reflexes increases the likelihood of an intracranial process.

scholarly journals TRENDS, PREDICTORS, AND OUTCOMES OF PERCUTANEOUS CORONARY INTERVENTION COMPLICATED BY IN-HOSPITAL CARDIAC ARREST

2021 ◽  
Vol 77 (18) ◽  
pp. 203
Author(s):  
Temidayo Abe ◽  
Titilope Olanipekun ◽  
Valery S. Effoe ◽  
Joseph Igwe ◽  
Obiora Egbuche ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiac Arrest ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Hospital Cardiac Arrest

Gender disparities in percutaneous coronary intervention in out-of-hospital cardiac arrest

2019 ◽  
Vol 37 (4) ◽  
pp. 632-638 ◽  
Author(s):  
Jin Seop Jeong ◽  
So Yeon Kong ◽  
Sang Do Shin ◽  
Young Sun Ro ◽  
Kyoung Jun Song ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiac Arrest ◽  
Coronary Intervention ◽  
Gender Disparities ◽  
Percutaneous Coronary ◽  
Hospital Cardiac Arrest

Abstract 11324: Immediate Percutaneous Coronary Intervention in Patients with Refractory Out of Hospital Cardiac Arrest

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Daniel Rob ◽  
Jana Smalcova ◽  
Tomas Kovarnik ◽  
David Zemanek ◽  
Ales Kral ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiac Arrest ◽  
Lower Risk ◽  
Coronary Intervention ◽  
Post Hoc Analysis ◽  
Risk Of Death ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Post Hoc ◽  
Hospital Cardiac Arrest

Background: An increasing number of cardiac centres are using immediate percutaneous coronary intervention (PCI) and extracorporeal cardiopulmonary resuscitation (ECPR) in patients with refractory out of hospital cardiac arrest (r-OHCA). Published evidence regarding PCI in OHCA has been mainly reporting to patients with early return of spontaneous circulation and the influence of PCI and ECPR on survival in the population of patients with r-OHCA and acute coronary syndrome (ACS) remains unclear. Methods: In this post hoc analysis of the randomized r-OHCA trial, all patients with ACS as a cause of r-OHCA were included. The effect of successful PCI and ECPR on 180-days survival was examined using Kaplan-Meier estimates and multivariable Cox regression. Results: In total, 256 patients were evaluated in Prague OHCA study and 127 (49.6 %) had ACS as the cause of r-OHCA constituting current study population. The mean age was 58 years (46.3-64) and duration of resuscitation was 52.5 minutes (36.5-68). ECPR was used in 51 (40.2 %) of patients. Immediate PCI was performed in 86 (67.7%) patients and TIMI flow 2 or 3 was achieved in 75 (87.2%) patients. The overall 180-days survival of patients with successful PCI was 40 % compared to 7.7 % with no or failed immediate PCI (log-rank p < 0.001). After adjustment for confounders, successful PCI was associated with a lower risk of death (HR 0.47, CI 0.24-0.93, p = 0.031). Likewise, ECPR was associated with a lower risk of death (HR 0.11, CI 0.05-0.24, p< 0.001). Conclusion: In this post hoc analysis of the randomized r-OHCA trial, successful immediate PCI as well as ECPR were associated with improved 180-days survival in patients with r-OHCA due to ACS.

Abstract 11372: A Risk-Adjustment Model for Patients Presenting to Hospitals with Out-of-Hospital Cardiac Arrest and ST-Elevation Myocardial Infarction

Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Andy T Tran ◽  
Anthony Hart ◽  
John Spertus ◽  
Philip Jones ◽  
Bryan McNally ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Risk Adjustment ◽  
Quality Measures ◽  
Coronary Intervention ◽  
Spontaneous Circulation ◽  
Logistic Regression Models ◽  
Adjustment Model ◽  
Risk Adjustment Model ◽  
Hospital Cardiac Arrest

Background: Given the diversity of patients resuscitated from out-of-hospital cardiac arrest (OHCA) complicated by STEMI, adequate risk adjustment is needed to account for potential differences in case-mix to reflect the quality of percutaneous coronary intervention. Objectives: We sought to build a risk-adjustment model of in-hospital mortality outcomes for patients with OHCA and STEMI requiring emergent angiography. Methods: Within the Cardiac Arrest Registry to Enhance Survival, we included adult patients with OHCA and STEMI who underwent angiography within 2 hours from January 2013 to December 2019. Using pre-hospital patient and arrest characteristics, multivariable logistic regression models were developed for in-hospital mortality. We then described model calibration, discrimination, and variability in patients’ unadjusted and adjusted mortality rates. Results: Of 2,999 hospitalized patients with OHCA and STEMI who underwent emergent angiography (mean age 61.2 ±12.0, 23.1% female, 64.6% white), 996 (33.2%) died. The final risk-adjustment model for mortality included higher age, unwitnessed arrest, non-shockable rhythms, not having sustained return of spontaneous circulation upon hospital arrival, and higher total resuscitation time on scene ( C -statistic, 0.804 with excellent calibration). The risk-adjusted proportion of patients died varied substantially and ranged from 7.8% at the 10 th percentile to 74.5% at the 90 th percentile (Figure). Conclusions: Through leveraging data from a large, multi-site registry of OHCA patients, we identified several key factors for better risk-adjustment for mortality-based quality measures. We found that STEMI patients with OHCA have highly variable mortality risk and should not be considered as a single category in public reporting. These findings can lay the foundation to build quality measures to further optimize care for the patient with OHCA and STEMI.

scholarly journals Sex differences in out-of-hospital cardiac arrest

Aging ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 5588-5589
Author(s):  
Iris Oving ◽  
Marieke T. Blom ◽  
Hanno L. Tan
Keyword(s):  
Cardiac Arrest ◽  
Sex Differences ◽  
Hospital Cardiac Arrest
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