Influence of comorbidities and clinical prediction model on neurological prognostication post out-of-hospital cardiac arrest

Huang, Weiting; Teo, Gary Kuan Wee; Tan, Jack Wei-Chieh; Ahmad, Nur Shahidah Binte; Koh, Hwee Hong; Ong, Marcus Eng Hock

doi:10.1136/heartasia-2018-011016

Cited by 5 publications

(9 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study also showed a time from arrest to chest compression of 22 min, which was close to that in a previous study in Thailand (20 min) 7 . Furthermore, our study had a shorter total CPR duration (33 min) than a study in Singapore (38 min) 32 …”

Section: Discussionmentioning

confidence: 74%

“…Previous reports have demonstrated that a shockable cardiac rhythm including VF and pulseless VT on admission is an independent factor for the survival of OHCA patients 4,21,32 . However, the incidence of VF as the initial rhythm declined over time after the occurrence of OHCA.…”

Section: Discussionmentioning

confidence: 92%

“…7 Furthermore, our study had a shorter total CPR duration (33 min) than a study in Singapore (38 min). 32 The multivariate logistic regression analysis indicated that the independent factors associated with sustained ROSC included witnessed arrest, a time from arrest to chest compression of <15 min and a chest compression duration of <30 min. Our findings agree with those of previous reports that showed that the time from arrest to chest compression and duration from the scene to the healthcare centre are important for determining the outcomes of OHCA patients.…”

Section: Discussionmentioning

confidence: 97%

See 2 more Smart Citations

Predictive model of return of spontaneous circulation among patients with out‐of‐hospital cardiac arrest in Thailand: The WATCH‐CPR Score

et al. 2020

View full text Add to dashboard Cite

Background Out‐of‐hospital cardiac arrest is an emergency that requires immediate management to save lives. However, some predictive scores for the immediate outcomes of patients with out‐of‐hospital cardiac arrest are difficult to use in clinical practice. Aims This study aimed to identify predictors of sustained return of spontaneous circulation and to develop a predictive score. Methods This prospective observational study evaluated sustained return of spontaneous circulation among out‐of‐hospital cardiac arrest patients in a Thai emergency department between July 2014 and March 2018. The baseline characteristics and prehospital and hospital findings were analysed. Results Of 347 patients, 126 (36.3%) had sustained return of spontaneous circulation and 20 (5.8%) were discharged. Witnessed arrest (odds ratio = 2.9, 95% confidence interval 1.3‐6.2), time from arrest to chest compression <15 min (odds ratio = 3.0, 95% confidence interval 1.3‐7.0) and chest compression duration <30 min (odds ratio = 15.6, 95% confidence interval 8.7‐28.0) predicted sustained return of spontaneous circulation; these were developed into the WATCH‐CPR (Witnessed Arrest, Time from arrest to CHest compression‐CPR duration) score. A score of ≥2 was optimal for predicting sustained return of spontaneous circulation, which provided an area under the receiver operating characteristic of 0.775 (95% confidence interval 0.724‐0.825) and a sensitivity of 72.2% (95% confidence interval 63.4‐79.6%) and specificity of 76.0% (95% confidence interval 69.8‐81.4%). Conclusions The factors including witnessed arrest, time from arrest to chest compression and chest compression duration were developed as the WATCH‐CPR score for predicting sustained return of spontaneous circulation among patients with out‐of‐hospital cardiac arrest.

show abstract

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Predictive model of return of spontaneous circulation among patients with out‐of‐hospital cardiac arrest in Thailand: The WATCH‐CPR Score

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Targeted temperature management with mild hypothermia of 32°C-36°C (89.6°F-96.8°F) is recommended in the resuscitation guidelines. [24][25][26] Early supplementation of levosimendan, 27-29 a non-catecholamine calcium sensitizer, with intravenous epinephrine has been shown to improve the initial outcomes of cardiopulmonary resuscitation in animal studies. [30][31][32][33] Future studies can investigate further on the post-OHCA resuscitation measures to improve the clinical outcomes of survivors.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Prehospital Epinephrine in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis

Teoh

2019

Prehosp. Disaster med.

View full text Add to dashboard Cite

Introduction:Epinephrine has been recommended for out-of-hospital cardiac arrest (OHCA) resuscitation for nearly one century, but its efficacy and safety remain unclear in the literature. The primary aim of this review was to determine whether epinephrine increases the return of spontaneous circulation in OHCA patients.Methods:A systematic review and meta-analysis were conducted using the following databases: MEDLINE, EMBASE, and CENTRAL, from their inception until October 2018. All the randomized controlled trials (RCTs) were included. Observational studies, case reports, case series, and non-systematic reviews were excluded.Results:Two trials including 8,548 patients were eligible for inclusion in the data synthesis. In patients who received epinephrine during OHCA, the incidence of return of spontaneous circulation was increased, with an odds ratio (95%CI) of 4.25 (3.79-4.75), P <.001, high-quality of evidence. The number of patients transported to hospital was increased in patients who had prehospital epinephrine, with an odds ratio (95%CI) of 2.31 (2.11-2.53), P <.001, high-quality of evidence. The prehospital use of epinephrine was associated with an increased survival to hospital discharge, the odds ratio (95%CI) being 1.43 (1.10-1.87), P = .008, moderate-quality of evidence. No significant effect was noted on the favorable neurologic state of patient at hospital discharge, with an odds ratio (95%CI) of 1.21 (0.90-1.64), P = .21, moderate-quality of evidence.Conclusions:This meta-analysis suggests that the prehospital use of epinephrine increases return of spontaneous circulation, transport of patients to hospital, and survival to hospital discharge for OHCA. However, no significant effects on favorable neurologic function at hospital discharge were demonstrated. The general quality of evidence ranged from moderate to high.

show abstract

“…A few epidemiological studies have emphasized the importance of post-resuscitation care and have reported the long-term survival rates and neurological outcomes of pediatric OHCA patients (25)(26)(27)(28); however, detailed information regarding PDDs is not available, especially regarding the disease onset times, which are unclear. In this study, we aimed to report detailed information on the PDDs of traumatic and nontraumatic pediatric OHCA survivors with a 1-year follow-up time using a national healthcare database.…”

Section: Introductionmentioning

confidence: 99%

Demographics of Pediatric OHCA Survivors With Postdischarge Diseases: A National Population-Based Follow-Up Study

et al. 2020

View full text Add to dashboard Cite

Background: Postdischarge diseases (PDDs) have been reported for adult survivors of out-of-hospital cardiac arrest (OHCA). However, the detailed demographics of pediatric OHCA survivors with PDDs are not well-documented, and information regarding functional survivors is particularly limited. We aimed to report detailed information on the PDDs of survivors of traumatic and non-traumatic pediatric OHCA using a national healthcare database. Methods: We retrospectively obtained data from the Taiwan government healthcare database (2011-2015). Information on the demographics of traumatic and non-traumatic pediatric OHCA survivors (<20 years) was obtained and reported. The patients who survived to discharge (survivors) and those classified as functional survivors were followed up for 1 year for the analysis of newly diagnosed PDDs. The time from discharge to PDD diagnosis was also reported. Results: A total of 2,178 non-traumatic and 288 traumatic OHCA pediatric cases were included. Among the non-traumatic OHCA survivors (n = 374, survival rate = 17.2%), respiratory tract (n = 270, 72.2%), gastrointestinal (n = 187, 50.0%), and neurological diseases (n = 167, 49.1%) were the three most common PDD categories, and in these three categories, the majority of PDDs were atypical/influenza pneumonia, non-infective acute gastroenteritis, and generalized/status epilepsy, respectively. Among the traumatic OHCA survivors (n = 21, survival rate = 7.3%), respiratory tract diseases (n = 17, 81.0%) were the most common, followed by skin or soft tissue (n = 14, 66.7%) diseases. Most functional survivors still suffered from neurological and respiratory tract diseases. Most PDDs, except for skin or soft tissue diseases, were newly diagnosed within the first 3 months after discharge. Lee et al. Postdischarge Diseases of OHCA Survivors Conclusions: Respiratory tract (pneumonia), neurological (epilepsy), and skin or soft tissue (dermatitis) diseases were very common among both non-traumatic and traumatic OHCA survivors. More importantly, most PDDs, except for skin or soft tissue diseases, were newly diagnosed within the first 3 months after discharge.

show abstract

Influence of comorbidities and clinical prediction model on neurological prognostication post out-of-hospital cardiac arrest

Cited by 5 publications

References 21 publications

Predictive model of return of spontaneous circulation among patients with out‐of‐hospital cardiac arrest in Thailand: The WATCH‐CPR Score

Predictive model of return of spontaneous circulation among patients with out‐of‐hospital cardiac arrest in Thailand: The WATCH‐CPR Score

The Effect of Prehospital Epinephrine in Out-of-Hospital Cardiac Arrest: A Systematic Review and Meta-Analysis

Demographics of Pediatric OHCA Survivors With Postdischarge Diseases: A National Population-Based Follow-Up Study

Contact Info

Product

Resources

About