Cardiac arrest: prognostic factors and outcome at one year

Beuret, Philippe; Feihl, François; Vogt, Pierre; Perret, Anne; Romand, Jacques-André; Perret, C

doi:10.1016/0300-9572(93)90093-6

Cited by 70 publications

(27 citation statements)

References 29 publications

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“…Nevertheless, acceptable neurological recovery has been reported even after prolonged CPR (Krug 1986). However, prolonged CPR seemed to affect the immediate survival and survival to hospital discharge in our study just as negatively as it did in other reported studies (Woog and Torzillo 1987;Murphy et al 1989;Beuret 1993;Gwinnut et al 2000).…”

Section: Discussionsupporting

confidence: 66%

“…Successful cardiopulmonary resuscitation (CPR) after in-hospital cardiac arrest and its effect on subsequent quality of life depend on the availability of basic and advanced life support systems, the ability to immediately defibrillate the arrested heart, and the quality of the CPR intervention (Beuret et al 1993;Jorgensen 1997). Assessing the effectiveness and quality of current CPR strategies, however, is difficult because it requires the systematic collection and review of data on in-hospital cardiac arrest.…”

mentioning

confidence: 99%

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Assessment of In-Hospital Cardiopulmonary Resuscitation Using Utstein Template in a University Hospital

Tok

Keleş

Toprak

et al. 2004

Tohoku J. Exp. Med.

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Section: Discussionsupporting

confidence: 66%

mentioning

confidence: 99%

Assessment of In-Hospital Cardiopulmonary Resuscitation Using Utstein Template in a University Hospital

Tok

Keleş

Toprak

et al. 2004

Tohoku J. Exp. Med.

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“…The subset of 10 studies meeting the strict inclusion criteria included 2,434 patients. Among the 41 studies that met the minimal criteria, 12 took place in Europe, 13,15,17,19,28,31,38,[40][41][42][43][44]48 one each in Australia, 22 Israel, 24 and Japan, 30 12 (1983) 294 All adults Y x x x Gulati et al 13 (1983) 52 Adults Ն age 64 N x Scaff et al 14 (1984) 242 All adults N x x Sowden et al 15 (1984) 108 All adults N x ? ?…”

Section: Discussionmentioning

confidence: 99%

“…48,56 One study was excluded because only a single patient met the inclusion criteria. 49 Four of the studies included in the analysis either children 31,41 or out-of-hospital arrests, 41,42 but presented their data in such a way that these nonqualifying cases could be excluded from the analysis. A total of 41 studies met the minimal inclusion criteria, while only 10 studies met the strict inclusion criteria.…”

Section: Data Abstractionmentioning

confidence: 99%

Survival after in-hospital cardiopulmonary resuscitation

et al. 1998

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OBJECTIVE:To determine the rates of immediate survival and survival to discharge for adult patients undergoing in-hospital cardiopulmonary resuscitation, and to identify demographic and clinical variables associated with these outcomes. MEASUREMENTS AND MAIN RESULTS:The MEDLARS database of the National Library of Medicine was searched. In addition, the authors' extensive personal files and the bibliography of each identified study were searched for further studies. Two sets of inclusion criteria were used, minimal (any study of adults undergoing in-hospital cardiopulmonary resuscitation) and strict (included only patients from general ward and intensive care units, and adequately defined cardiopulmonary arrest and resuscitation). Each study was independently reviewed and abstracted in a nonblinded fashion by two reviewers. The data abstracted were compared, and any discrepancies were resolved by consensus discussion. For the subset of studies meeting the strict criteria, the overall rate of immediate survival was 40.7% and the rate of survival to discharge was 13.4%. The following variables were associated with failure to survive to discharge: sepsis on the day prior to resuscitation (odds ratio T he do-not-resuscitate (DNR) order has become well accepted and widely used in American hospitals, and for the majority of patients who die in the hospital, a DNR order has been written by the time of their death. 1-3 The decision to discuss or execute a DNR order is driven by several concerns: the patient's current quality of life, the likelihood that cardiopulmonary resuscitation (CPR) will be successful, the patient's long-term prognosis following successful resuscitation, and his or her anticipated quality of life following successful resuscitation. 4,5 Although judgments about quality of life are best assessed by the patient, physicians have typically been relied on to provide biomedical information and estimates of prognosis; this is consistent with a shared approach to medical decision making. Information about prognosis can either be communicated implicitly (e.g., "I don't think CPR is likely to help you") or explicitly ("Patients with your condition have a less than 1% chance of surviving to discharge after CPR"). The explicit approach has been shown in two studies to influence patient decisions about DNR orders, 6,7 so it is important that prognostic information be as accurate as possible.[Recent work has shown, however, that physicians are not accurate in predicting the outcome of CPR. In fact, when presented with detailed vignettes of actual patient cases, physician predictions of the likelihood of immediate survival following CPR were no better than random guessing, with an area under the receiver-operating characteristic (ROC) curve not significantly different from 0.5. 8 An analysis with the physician prediction of the likelihood of survival as the outcome variable in a multivariate regression shows that physicians appear to have an underlying cognitive model. However, this model overemphasizes the imp...

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“…Clinically important cognitive impairment has been reported for 20% to 50% of the cases. [5][6][7] In a previous study, our group investigated the prevalence of chronic memory impairment among OHCA survivors. Moderate or severe impairment, assessed by the Rivermead Behavioural Memory Test (RBMT), was noted in almost 40% of the individuals assessed 6 months after cardiac arrest.…”

mentioning

confidence: 99%

Memory Impairment in Out-of-Hospital Cardiac Arrest Survivors Is Associated With Global Reduction in Brain Volume, Not Focal Hippocampal Injury

Grubb

Fox

Smith

et al. 2000

Stroke

111

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Background and Purpose-More than 30% of out-of-hospital cardiac arrest (OHCA) survivors suffer significant memory impairment. The hippocampus may be vulnerable to hypoxic injury during cardiac arrest. The purpose of this study was to determine whether selective hippocampal injury is the substrate for this memory impairment. Methods-Seventeen OHCA survivors and 12 patients with uncomplicated myocardial infarction were studied. OHCA survivors were divided into those with impaired and intact memory.

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Cardiac arrest: prognostic factors and outcome at one year

Cited by 70 publications

References 29 publications

Assessment of In-Hospital Cardiopulmonary Resuscitation Using Utstein Template in a University Hospital

Assessment of In-Hospital Cardiopulmonary Resuscitation Using Utstein Template in a University Hospital

Survival after in-hospital cardiopulmonary resuscitation

Memory Impairment in Out-of-Hospital Cardiac Arrest Survivors Is Associated With Global Reduction in Brain Volume, Not Focal Hippocampal Injury

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