Out-of-hospital cardiac arrest: 30-day survival and 1-year risk of anoxic brain damage or nursing home admission according to consciousness status at hospital arrival

Søndergaard, Kathrine Bach; Riddersholm, Signe; Wissenberg, Mads; Hansen, Steen Møller; Barcella, Carlo Alberto; Karlsson, Lena; Bundgaard, Karin; Lippert, Freddy; Kjærgaard, Jesper; Gislason, Gunnar; Folke, Fredrik; Torp‐Pedersen, Christian; Kragholm, Kristian

doi:10.1016/j.resuscitation.2019.12.006

Cited by 16 publications

(10 citation statements)

References 28 publications

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“…In a study from Denmark involving 13,953 patients with OHCA, on hospital arrival 776 (5.6%) had ROSC and were conscious, 5205 (37.3%) had ROSC, but were comatose, and 7972 (57.1%) had ongoing CPR at hospital arrival. 8 Most patients who were conscious on arrival were alive 30 days later (89.0% (95% confidence interval [CI] 86.8%-91.2%)) and few developed anoxic brain injury or required nursing home admission (2.4% (95% CI 1.2%-3.6%)). 8 The majority of patients who are comatose on arrival at hospital are admitted to an intensive care unit (ICU) where they spend on average 3-5 days and represent up to 10% of ICU admissions.…”

Section: Epidemiologymentioning

confidence: 99%

“…8 Most patients who were conscious on arrival were alive 30 days later (89.0% (95% confidence interval [CI] 86.8%-91.2%)) and few developed anoxic brain injury or required nursing home admission (2.4% (95% CI 1.2%-3.6%)). 8 The majority of patients who are comatose on arrival at hospital are admitted to an intensive care unit (ICU) where they spend on average 3-5 days and represent up to 10% of ICU admissions. 9,10 Here, attention is focused on identifying and treating the underlying cause of the cardiac arrest and optimising neurological recovery.…”

Section: Epidemiologymentioning

confidence: 99%

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Brain injury after cardiac arrest

et al. 2021

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Section: Epidemiologymentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

Brain injury after cardiac arrest

et al. 2021

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“…Under the early initiation of high-quality cardiopulmonary resuscitation and defibrillation, a few patients could return of spontaneous circulation and consciousness. But the rate is very low, only 5.6% in a Danish study (Sondergaard et al 2020). Most patients remain comatose upon arrival at the hospital and are discharged into intensive care until (Perkins et al 2021).…”

Section: Introductionmentioning

confidence: 95%

Identification of predictors for neurological outcome after cardiac arrest in peripheral blood mononuclear cells through integrated bioinformatics analysis and machine learning

Qin

Liu

et al. 2023

Funct Integr Genomics

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Neurological prognostication after cardiac arrest (CA) is important to avoid pursuing futile treatments for poor outcome and inappropriate withdrawal of life-sustaining treatment for good outcome. To predict neurological outcome after CA through biomarkers in peripheral blood mononuclear cells, four datasets were downloaded from the Gene Expression Omnibus database. GSE29546 and GSE74198 were used as training datasets, while GSE92696 and GSE34643 were used as verification datasets. The intersection of differentially expressed genes and hub genes from multiscale embedded gene co-expression network analysis (MEGENA) was utilized in the machine learning screening. Key genes were identified using support vector machine recursive feature elimination (SVM-RFE), least absolute shrinkage and selection operator (LASSO) logistic regression, and random forests (RF). The results were validated using receiver operating characteristic curve analysis. An mRNA-miRNA network was constructed. The distribution of immune cells was evaluated using cell-type identification by estimating relative subsets of RNA transcripts (CIBERSORT). Five biomarkers were identified as predictors for neurological outcome after CA, with an area under the curve (AUC) greater than 0.7: CASP8 and FADD-like apoptosis regulator (CFLAR), human protein kinase X (PRKX), miR-483-5p, let-7a-5p, and let-7c-5p. Interestingly, the combination of CFLAR minus PRKX showed an even higher AUC of 0.814. The mRNA-miRNA network consisted of 30 nodes and 76 edges. Statistical differences were found in immune cell distribution, including neutrophils, NK cells active, NK cells resting, T cells CD4 memory activated, T cells CD4 memory resting, T cells CD8, B cells memory, and mast cells resting between individuals with good and poor neurological outcome after CA. In conclusion, our study identified novel predictors for neurological outcome after CA. Further clinical and laboratory studies are needed to validate our findings.

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“…1,27 Early bystander and first responder treatment resulted in regained consciousness for 6 of 13 survivors even before EMS arrival, a factor previously associated with improved outcome. 28 This may also explain the observed OR of 1.58 for survival at Copenhagen International Airport compared to bystander witnessed OHCA in public locations in the rest of Denmark, which would seem a comparable reference group. The high proportion of bystander intervention and rapid first responder involvement observed in this study may prove to be important for long-term survival, neurological outcome, and health related quality of life as well.…”

Section: Discussionmentioning

confidence: 93%

Bystander interventions and survival following out-of-hospital cardiac arrest at Copenhagen International Airport

et al. 2021

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Aim: To examine incidence and outcome following out-of-hospital cardiac (OHCA) arrest in a high-risk area characterised by high density of potential bystanders and easy access to nearby automated external defibrillators (AEDs). Methods: This retrospective observational study investigated pre-hospital and in-hospital treatment, as well as survival amongst persons with OHCA at Copenhagen International Airport between May 25, 2015 and May 25, 2019. OHCA data from pre-and in-hospital medical records were obtained and compared with public bystander witnessed OHCAs in Denmark. Results: Of the 23 identified non-traumatic OHCAs, 91.3% were witnessed by bystanders, 73.9% received bystander cardiopulmonary resuscitation (CPR), and 43.5% were defibrillated by a bystander. Survival to hospital discharge was 56.5%, with 100% survival among persons with an initial shockable heart rhythm. Compared with nationwide bystander witnessed OHCAs, persons with OHCA at the airport were less likely to receive bystander CPR (73.9% vs. 89.4%, OR 0.33; 95% CI, 0.13À0.86), more likely to receive bystander defibrillation (43.5% vs. 24.8%, OR 2.32; 95% CI, 1.01À5.31), to achieve return of spontaneous circulation (78.2% vs. 50.6%, OR 3.51; 95% CI, 1.30À9.49), and survive to hospital discharge (56.5% vs. 45.2%, OR 1.58; 95% CI, 0.69À3.62). Conclusion: We found a high proportion of bystander defibrillation indicating that bystanders will quickly apply an AED, when accessible. Importantly, 56% of all persons, and all persons with a shockable heart rhythm survived. These findings suggest increased potential for survival following OHCA and support current guidelines to strategically deploy accessible AEDs in high-risk OHCA areas.

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Out-of-hospital cardiac arrest: 30-day survival and 1-year risk of anoxic brain damage or nursing home admission according to consciousness status at hospital arrival

Cited by 16 publications

References 28 publications

Brain injury after cardiac arrest

Brain injury after cardiac arrest

Identification of predictors for neurological outcome after cardiac arrest in peripheral blood mononuclear cells through integrated bioinformatics analysis and machine learning

Bystander interventions and survival following out-of-hospital cardiac arrest at Copenhagen International Airport

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