Long-term survival after prehospital cardiac arrest: analysis of outcome during an 8 year study.

Abstract

We analyzed long-term follow-up data accumulated during an 8 year study of survivors of prehospital cardiac arrest. All patients included in this study were DURING THE PAST 15 years. the success of community-based systems for intervention in prehospital cardiac arrest has established a new population of patients -the survivors of prehospital cardiac arrest who require highly specialized medical attention because of the risk of recurrent cardiac arrest.`Survival after cardiac arrest can be measured in three distinct time frames: (1) from the onset of cardiac arrest to hospitalization, (2) from the period of initial in-hospital care to discharge, and (3) as long-term outcome in patients who have been discharged from the hospital. The earli- Presented in part at the 56th Scientific Sessions of The American Heart Association, Anaheim, CA. November, 1983. est available data were discouraging with respect to outcome in each of these periods: a 60% to 70% prehospital mortality rate, a 50% to 60% mortality rate in hospitalized patients (i.e., 10% to 15% of the total prehospital arrest population survived both prehospital and in-hospital care), and a 45% 24 month rate of recurrence of cardiac arrest among posthospital survivors.

Cardiac catheterization is underutilized after in-hospital cardiac arrest

“…Acute coronary artery occlusion has been identified as the etiology of arrest in up to 48% of post-arrest survivors 1. In autopsy series, coronary artery thrombi or atherosclerotic plaque fissuring have been identified in up to 95% of patients with sudden cardiac death 2, 3. Identifying post-arrest patients likely to have acute coronary artery occlusion can be challenging because electrocardiographic (ECG) findings and clinical data may be unreliable in this population.…”

A seven-year follow-up of discharged patients after out-of-hospital cardiac arrest with respect to ST-segment elevation myocardial infarction

“…survival in 53 patients, from discharge after OHCA of "primary cardiac" aetiology, between 2002 to 2004. In comparison with the reference literature, we demonstrated that the initial numbers of patients sampled ranged from 48 to 95 patients, (4,11,16,19,20) and 139 to 680 patients. (1,2,5,7,17,(21)(22)(23) Most of these studies are however retrospective in nature with data obtained from central registers.…”

Current status of implantable cardioverter-defibrillator therapy in heart failure

“…Patients who have been successfully resuscitated from cardiac arrest remain at risk for developing future lifethreatening ventricular arrhythmias [17,18]. The AVID trial is the fi rst and largest secondary prevention trial, enrolling 1016 patients who were resuscitated from VF, sustained VT with syncope, or sustained VT with an ejection fraction of 40% or less, and had symptoms suggestive of severe hemodynamic compromise.…”