In-hospital mode of death after out-of-hospital cardiac arrest

Wittwer, M.; Armstrong, Thomas J.; Conway, Jordan W.; Ruknuddeen, Mohammed Ishaq; Zeitz, Chris; Beltrame, John F.; Arstall, Margaret

doi:10.1016/j.resplu.2022.100229

Cited by 15 publications

(5 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We included the results of prognostic test to analyze the association between sex and end-of-life decisions. Although only small proportion of our cohort had WLST, women had rates of WLST and other LAT similar to those of men, which is in contrast to some previous studies but not others [ 8 , 19 , 32 ]. The increase in age and the absence of brainstem reflex and an N20 peak on SSEP (or >2 poor outcome predictors) were independently associated with these decisions but not sex.…”

Section: Discussioncontrasting

confidence: 96%

Sex Difference on Neurological Outcomes and Post-Cardiac Arrest Care in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management: Post-Hoc Study of a Prospective, Multicenter, Observational Cohort Study

Park

et al. 2023

JCM

View full text Add to dashboard Cite

Conflicting results regarding sex-based differences in the outcomes of out-of-hospital cardiac arrest (OHCA) patients have been reported. We aimed to evaluate the association between sex and neurological outcome as well as various in-hospital process in OHCA patients treated with targeted temperature management. We retrospectively analyzed a prospective registry data collected between October 2015 and December 2018. To evaluate the effect of sex on patient outcomes, we created various multivariable logistic regression models. When the results were adjusted using resuscitation variables and in-hospital variables, there was no significant difference (OR = 1.22, 95% CI: 0.85–1.74; OR = 1.13, 95 CI: 0.76–1.68, respectively). Regarding the in-hospital course, the daily total SOFA score was similar in both sexes, whereas cardiovascular scores were higher in women on days 2 and 3. The adjusted effect of sex was not associated with the clinician’s decision to perform early cardiac interventions, except for those men that had more extracorporeal membrane oxygenation (OR = 2.51, 95% CI: 1.11–5.66). The findings seems that men had more favorable 6-month neurological outcomes. However, after adjusting for confounders, there was no difference between the sexes. The results regarding in-hospital course were similar in men and women.

show abstract

Section: Discussioncontrasting

confidence: 96%

Sex Difference on Neurological Outcomes and Post-Cardiac Arrest Care in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management: Post-Hoc Study of a Prospective, Multicenter, Observational Cohort Study

Park

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…However, no study has included the results of prognostic tests to analyze the impact of sex on end-of-life decisions. In univariate analysis, women had rates of WLST and other limiting LST similar to those of men, which is in contrast to some previous studies but not others [8,32]. When evaluating the independent factors of decisions regarding LST by multivariate logistic regression, the increase in age and the absence of brainstem re ex and an N20 peak on SSEP (or > 2 poor outcome predictors) were associated but not sex.…”

Section: Discussioncontrasting

confidence: 74%

Sex difference on neurological outcomes and post-cardiac arrest care in out-of-hospital cardiac arrest patients treated with targeted temperature management

Park

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: Conflicting results regarding sex-based differences in the outcomes of out-of-hospital cardiac arrest (OHCA) patients have been reported. Furthermore, no study has examined whether differences in in-hospital interventions and courses are driven by sex. This study evaluated the effect of sex on the in-hospital course as well as the survival rates and long-term neurological outcomes of OHCA patients treated with targeted temperature management.Methods: We retrospectively analyzed the Korean Hypothermia Network Prospective Registry composed of data collected from 22 hospitals in Korea between October 2015 and December 2018. To evaluate the effect of sex on patient outcomes, we created various multivariate logistic regression models. Regarding the difference in in-hospital courses, we compared daily total and SOFA sub-scores between the sexes and analyzed whether the decision regarding early cardiac interventions and limitations in in-hospital care were associated with sex.Results: The rate of good neurological outcomes after 6 months was higher in men (OR = 1.66, 95% CI: 1.26 2.17). However, when the results were adjusted using resuscitation variables and in-hospital variables were added, there was no significant difference between the two sexes (OR =1.22, 95% CI: 0.85 – 1.74; OR = 1.13, 95 CI: 0.76 – 1.68, respectively). There was no association between sex and outcome in patients of reproductive age and no interaction between age and sex. Regarding the in-hospital course, the daily total SOFA score was similar in both sexes whereas cardiovascular scores were higher in women on 2 and 3 days (on day 2, p = 0.006; on day 3, p = 0.017). The adjusted effect of sex was not associated with the clinician’s decision to perform early cardiac interventions except that men had more extracorporeal membrane oxygenation (ECMO) (OR=2.51, 95% CI: 1.11-5.66). The decision to discontinue life-sustaining treatment was determined by poor prognostic factors, not by sex. Conclusions: The findings suggested that men had more favorable 6-month neurological outcomes. However, after adjusting for confounders, there was no difference between the sexes. The results regarding in-hospital course were similar in men and women.

show abstract

“…Severe hypoxic ischemic encephalopathy (HIE), which develops from hours to days after resuscitation, is the primary cause of death among comatose survivors of cardiac arrest. 1 , 2 , 3 Identifying patients with poor neurological outcome among comatose survivors is challenging due to the delayed presentation of the extent of the brain injury. Yet, this assessment of neurologic prognosis is vital to enable adequate decisions to withdraw life-sustaining therapy (WLST).…”

Section: Introductionmentioning

confidence: 99%

The capacity of neurological pupil index to predict the absence of somatosensory evoked potentials after cardiac arrest – An observational study

Thuccani,

Joelsson,

Lilja

et al. 2024

Resuscitation Plus

View full text Add to dashboard Cite

In-hospital mode of death after out-of-hospital cardiac arrest

Cited by 15 publications

References 29 publications

Sex Difference on Neurological Outcomes and Post-Cardiac Arrest Care in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management: Post-Hoc Study of a Prospective, Multicenter, Observational Cohort Study

Sex Difference on Neurological Outcomes and Post-Cardiac Arrest Care in Out-of-Hospital Cardiac Arrest Patients Treated with Targeted Temperature Management: Post-Hoc Study of a Prospective, Multicenter, Observational Cohort Study

Sex difference on neurological outcomes and post-cardiac arrest care in out-of-hospital cardiac arrest patients treated with targeted temperature management

The capacity of neurological pupil index to predict the absence of somatosensory evoked potentials after cardiac arrest – An observational study

Contact Info

Product

Resources

About