Highlights
- •Data regarding clinical long-term outcomes after OHCA are scarce.
- •OHCA survivors face significant morbidity and mortality after the index event.
- •Neurological outcome, time from CA to CPR, age and LVEF were predictors of worse f/u.
- •Clinically relevant events during f/u were not always directly related with the CA.
- •Survivors may benefit from multidisciplinary teams providing integral management.
Abstract
Introduction and objectives
Information regarding long-term outcomes in patients surviving out-of-hospital cardiac
arrest (OHCA) is scarce. Our aim was to study the long-term clinical outcomes of a
large cohort of OHCA patients surviving until hospital discharge and to identify predictors
of mortality and cardiovascular events.
Methods
Consecutive OHCA patients admitted in the Acute Cardiac Care Unit who survived at
least until hospital discharge between 2007 and 2019 were included. All received therapeutic
hypothermia according to the local protocol. Pre- and intra-hospital clinical and
analytical variables were analyzed, as well as the clinically relevant events during
follow-up.
Results
A total of 201 patients were included, with a mean age of 57.6 ± 14.2 years, 168 (83.6%)
were male. Thirty-six (17.9%) died during a median follow-up of 40.3 months (18.9–69.1),
the most frequent causes of death being cardiovascular and neurological, followed
by cancer. We calculated a predictive model for mortality during follow-up using Cox
regression that included the following variables: poor neurological outcome [HR 3.503
(1.578–7.777)], non-shockable rhythm [HR 2.926 (1.390–6.163)], time to onset of CPR
[HR 1.063 (0.997–1.134)], older age [1.036 (1.008–1.064)) and worse ejection fraction
at discharge [1.033 (1.009–1.058)].
Conclusions
Even though few patients experience recurrent cardiac arrest events, survivors after
OHCA face high morbidity and mortality during long-term follow-up. Therefore, they
may benefit from multidisciplinary teams providing an integral management and ensuring
continuity of care.
Keywords
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Article info
Publication history
Published online: December 19, 2019
Accepted:
November 30,
2019
Received in revised form:
November 13,
2019
Received:
September 18,
2019
Identification
Copyright
© 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
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Access this article on ScienceDirectLinked Article
- Cardiac arrest: The need for integrated multi-disciplinary actions for a continuum of care both in acute and at long-termEuropean Journal of Internal MedicineVol. 74
- PreviewOut-of-hospital cardiac arrest (OHCA) is a devastating and dramatic event, with a mortality of around 90% prior to hospitalization and a severe in-hospital outcome, since less than 6 percent of people who experience an OHCA survive to hospital discharge [1]. However, around half of the patients admitted to hospital who presented ventricular tachycardia or ventricular fibrillation at the time of resuscitation can nowadays survive and can be discharged from hospital with reasonable neurological conditions [2].
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