scholarly journals Cancer is not associated with higher short or long-term mortality after successful resuscitation from out-of-hospital cardiac arrest when adjusting for prognostic factors

2018 ◽  
Vol 9 (4_suppl) ◽  
pp. S184-S192 ◽  
Author(s):  
Matilde Winther-Jensen ◽  
Jesper Kjaergaard ◽  
Christian Hassager ◽  
Lars Køber ◽  
Freddy Lippert ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Prognostic Factors ◽  
Cerebral Performance Category ◽  
Successful Resuscitation ◽  
Performance Category ◽  
Patients With Cancer ◽  
The Impact ◽  
Hospital Cardiac Arrest ◽  
Long Term Mortality

Objective: As the prevalence of malignancies in the general population increases, the odds of an out-of-hospital cardiac arrest (OHCA) patient having a history of cancer likewise increases, and the impact on post-cardiac arrest care and mortality is not well known. We aimed to investigate 30-day and 1-year mortality after successful resuscitation in patients with cancer prior to OHCA compared with OHCA patients without a previous cancer diagnosis. Methods: A cohort of 993 consecutive OHCA patients with successful resuscitation during 2007–2011 was included. Vital status was obtained from the Danish Civil Register, and cancer diagnoses from the Danish National Patient Register dating back to 1994. Primary endpoints were 30-day, 1-year and long-term mortality (no cancer: mean 811 days; cancer: mean 406 days), analysed by Cox regression. Functional status assessed by cerebral performance category at discharge and use of post-resuscitation care were secondary endpoints. Results: A total of 119 patients (12%) were diagnosed with cancer prior to OHCA. Mortality was higher in patients with cancer (30-day 69% vs. 58%, P=0.01); however, after adjustment for prognostic factors cancer was no longer associated with higher mortality (hazard ratio (HR)30 days 0.98, 95% confidence interval (CI) 0.76–1.27, P=0.88; HR1 year 0.99, 95% CI 0.78–1.27, P=0.96 HRend of follow-up 0.95, 95% CI 0.75–1.20, P=0.67). Favourable cerebral performance category scores in patients alive at discharge did not differ (cerebral performance category 1 or 2 n=310 (84%) vs. n=31 (84%), P=1). Conclusion: Cancer prior to OHCA was not associated with higher mortality in patients successfully resuscitated from OHCA when adjusting for confounders. Cancer prior to OHCA should be used with caution when performing prognostication after OHCA.

Cerebral Performance Category and Long-Term Prognosis Following Out-of-Hospital Cardiac Arrest*

2013 ◽  
Vol 41 (5) ◽  
pp. 1252-1257 ◽  
Author(s):  
Randi Phelps ◽  
Florence Dumas ◽  
Charles Maynard ◽  
Jennifer Silver ◽  
Thomas Rea
Keyword(s):  
Cardiac Arrest ◽  
Cerebral Performance Category ◽  
Performance Category ◽  
Long Term Prognosis ◽  
Hospital Cardiac Arrest

Abstract 111: Impact of Time to Return of Spontaneous Circulation on Neurologically Intact Survival in Patients With Out-of-Hospital Cardiac Arrest According to Age: Evidence From a Large-Scale Registry in Japan

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Akira Funada ◽  
Yoshikazu Goto ◽  
Hayato Tada ◽  
Masaya Shimojima ◽  
Hirofumi Okada ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Large Scale ◽  
Cerebral Performance Category ◽  
Spontaneous Circulation ◽  
Performance Category ◽  
Return Of Spontaneous Circulation ◽  
The Impact ◽  
The Relationship ◽  
Neurologically Intact ◽  
Hospital Cardiac Arrest

Introduction: Time to return of spontaneous circulation (ROSC) is a more important predictor of neurologically intact survival than the presence of ROSC in patients with out-of-hospital cardiac arrest (OHCA). However, the differences in the relationship between time to ROSC and neurologically intact survival in patients with OHCA based on age is unclear. Hypothesis: We hypothesized that the impact of time to ROSC on neurologically intact survival differs according to age. Methods: We analyzed the data of 34,905 patients with OHCA (age ≥18 years) who exhibited prehospital ROSC from the prospectively recorded all-Japan OHCA registry (2011-2014). The primary outcome was neurologically intact survival at 1 month after OHCA (cerebral performance category [CPC] 1 or 2). Time to ROSC was defined as the interval from the initiation of cardiopulmonary resuscitation (CPR) by emergency medical service (EMS) providers to the achievement of ROSC. We categorized time to ROSC by every 4-min interval (2 cycles of CPR) from 1 to 32 min and ≥33 min, and age into 4 groups: 18-64, 65-74, 75-89, and ≥90 years. Results: The overall CPC 1-2 rate was 21.1% (7,353/34,905). Increasing time to ROSC (per min) was negatively associated with CPC 1-2 (adjusted odds ratio, 0.91; 95% confidence interval, 0.90-0.91). The CPC 1-2 rates decreased as time to ROSC increased in each age group: from 58.8% (1,247/2,122) in 1-4 min to 2.8% (7/246) in ≥33 min for patients aged 18-64 years, from 51.1% (721/1,410) in 1-4 min to 1.6% (4/244) in ≥33 min for 65-74 years, from 37.3% (765/2,051) in 1-4 min to 0.7% (4/539) in 29-32 min for 75-89 years, and from 23.4% (92/393) in 1-4 min to 0.2% (1/481) in 17-20 min for ≥90 years (all p for trend <0.001). Conclusions: The CPC 1-2 rates of patients aged 18-64 and 65-74 years were above the 1% futility rate when prehospital ROSC was achieved after prolonged CPR, ≥33 min from initiation by EMS providers. However, the CPC 1-2 rates were below the 1% futility rate when prehospital ROSC was achieved ≥29 min and ≥17 min for patients aged 75-89 years and ≥90 years, respectively.

Abstract 240: Are the Same Resuscitation Protocols Needed for Highly Aged Victims With Out-of-Hospital Cardiac Arrest as Middle or Younger Aged?

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Hiroyuki Hanada ◽  
Yoshio Tahara ◽  
Satoshi Yasuda ◽  
Teruo Noguchi ◽  
Kunihiro Nishimura ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Total Population ◽  
Cerebral Performance Category ◽  
Population Based ◽  
Aged Patients ◽  
Performance Category ◽  
Aging Society ◽  
Shockable Rhythm ◽  
Activity Of Daily Life ◽  
Hospital Cardiac Arrest

Backgrounds: The population of elderly people aged 65 years or older in 2014 is 33 million, and the aging rate (proportion of the total population) is 26.0% in Japan. Victims facing to out of hospital cardiac arrest (OHCA) are getting older and older. Emergency medical system (EMS) in Japan must do the same resuscitation protocols once called to the patient with OHCA, even when he or she is very old and activity of daily life is very low. We need to clarify whether same resuscitation protocols are required to very highly aged patients with OHCA or not. Methods and Results: From January 2005 through December 2014, we conducted a prospective, population-based, observational study involving the consecutive patients across Japan who had OHCA (n= 1,299,784). The percentage of patients with OHCA aged more than 80 years old was increasing from 37.1% in 2005 to 47.8% in 2014 by 1% each year. Survival at one month after OHCA with cerebral performance category (CPC) scale 1 or 2 were 4,368 out of total 318,590 OHCA (1.4%) in 80’s, 1043 out of 126,546 (0.8%) in 90’s, and 35 out of 5,544 (0.6%) in aged more than 100 (from 100 to 114). Survival at one month after OHCA with CPC scale 1 or 2 was 11.084 out of 234,366 (4.7%) in 50- 60’s. Patients with witnessed OHCA with shockable rhythm and by-stander CPR survived to CPC 1 or 2 at one month after OHCA were 8.0% in 80’s, 4.1% in 90’s, 0 in aged more than 100, and 22.2% in 50-60’s respectably. Conclusion: Number of survivors with CPC 1 or 2 were very few in patients with OHCA aged more than 80 years old, but still existed. Although the same resuscitation protocols are needed for highly aged victims with OHCA, another system which arrow EMS to stop resuscitation should be established in the highly aging society.

scholarly journals Impact of Cardiopulmonary Resuscitation Duration on the Neurological Outcomes of Out-of-Hospital Cardiac Arrest

2021 ◽  
Author(s):  
HISSAH ALBINALI ◽  
Arwa Alumran ◽  
Saja AlRayes
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Cerebral Performance Category ◽  
Bivariate Analysis ◽  
Neurological Outcomes ◽  
Risk Of Death ◽  
Secondary Hospital ◽  
The Impact ◽  
Hospital Cardiac Arrest

Abstract Background: Patients experiencing cardiac arrest outside medical facilities are at greater risk of death and might have negative neurological outcomes. Cardiopulmonary resuscitation duration affects neurological outcomes of such patients, which suggests that duration of CPR may be vital to patient outcomes.Objectives: The study aims to evaluate the impact of cardiopulmonary resuscitation duration on neurological outcome of patients who have suffered out-of-hospital cardiac arrest.Methods: Data were collected from emergency cases handled by a secondary hospital in industrial Jubail, Saudi Arabia, between 2015 and 2020. There were 257 out-of-hospital cardiac arrest cases, 236 of which resulted in death.Results: Bivariate analysis showed no significant association between cerebral performance category (CPC) outcomes and duration of CPR, gender and cause of death whereas there is statistically significant between CPC and age. (p = 0.001). However, a good CPC outcome was reported with a (mean) limited duration of 8.1 min of CPR; whereas, poor CPC outcomes were associated with prolonged periods of CPR, 13.2 min (mean). Similarly, youthfulness was associated with good CPC outcomes as revealed by the mean age of 5.8 years, whereas a mean rank of 14.9 years was aligned with a poor CPC outcome.Conclusion: Cardiopulmonary Resuscitation Duration out-of-hospital cardiac arrest does not significantly influence the patient neurological outcome in the current study hospital. Other variables may have a more significant effect.

Abstract 218: Novel Blood Biomarker Taurine and Glutamate for Early Predicting Outcomes After Out-of-hospital Cardiac Arrest

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Jing Li ◽  
Kevin Qin ◽  
Pratik B Doshi ◽  
Xiangdong Zhu ◽  
Pavitra Kotini-Shah ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cerebral Performance Category ◽  
Hospital Arrival ◽  
Performance Category ◽  
Time Points ◽  
Critical Elements ◽  
Glutamate Concentration ◽  
Blood Biomarker ◽  
Hospital Cardiac Arrest ◽  
Over Time

Introduction: Out-of-Hospital cardiac arrest (OHCA) is the leading cause of death with an overall survival rate of less than 10%. Organ failure and metabolic impairment are two critical elements of post-CA syndrome. Taurine and glutamate are amino acids that are expressed primarily in heart and brain. The compensatory release during osmotic stress, as seen in CA, amplifies reperfusion injury, heart stunning and brain edema. Thus, taurine and glutamate concentrations in blood likely reflects the extent of injury in the heart and brain following CA. Hypothesis: Plasma taurine and glutamate concentration correlates with CA outcomes. Methods: Adult OHCA patients (n=37) at an urban academic ED were enrolled from 2018-2019. Among them, 14 were survivors (S) and 23 were nonsurvivors (NS). Blood samples were collected at various time points including the time at hospital arrival, 6, 24, 48, 72 hours after arrival (T0, 6, 24, 48 and 72 h, respectively), and measured. T-test and GEE were used for mean comparison and longitudinal trend analysis, respectively. p < 0.05 was considered as statistically significant. Results: Plasma taurine and glutamate concentrations were compared between S and NS at T0 and across all time points. Both concentrations were significantly higher in NS vs S group at T0 (for taurine: 77.7 ± 40.0 in NS vs. 60.0 ± 31.9 μM in S, p =0.014; for glutamate: 176.4 ± 98.7 in NS vs. 162.8 ± 111.1 μM in S, p =0.0496), and showed a decreasing trend over time. In the first 6 h, taurine and glutamate level decreased more in S group than NS group (over 30% drop in S compared to <15% drop in NS). In addition, a positive correlation of cerebral performance category was seen at T6 with taurine (p=0.0354), but not with glutamate. Conclusions: Blood taurine and glutamate may serve as early biomarkers in predicting OHCA outcomes. Monitoring their change over time can help physicians tailor treatment decisions and patient management.

Time trends in long-term mortality after out-of-hospital cardiac arrest, 1980 to 1998, and predictors for death

2003 ◽  
Vol 145 (5) ◽  
pp. 826-833 ◽  
Author(s):  
Johan Engdahl ◽  
Angela Bång ◽  
Jonny Lindqvist ◽  
Johan Herlitz
Keyword(s):  
Cardiac Arrest ◽  
Time Trends ◽  
Hospital Cardiac Arrest ◽  
Long Term Mortality
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