Predicting factors for long-term survival in patients with out-of-hospital cardiac arrest – A propensity score-matched analysis

Lahmann, Anna Lena; Bongiovanni, Dario; Berkefeld, Anna; Kettern, Maximilian; Martinez, Lucas; Okrojek, Rainer; Hoppmann, Petra; Laugwitz, Karl‐Ludwig; Mayr, N. Patrick; Cassese, Salvatore; Byrne, Robert A.; Kufner, Sebastian; Xhepa, Erion; Schunkert, Heribert; Kastrati, Adnan

doi:10.1371/journal.pone.0218634

Cited by 10 publications

(5 citation statements)

References 29 publications

(33 reference statements)

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“…Despite that, according to our study results, early PCI was an independent predictor of intrahospital survival and ECG showing STEMI upon admission was an independent predictor of good neurological outcome. Similar results were published by Lahmann et al in their recently published study of 519 patients hospitalized after OHCA, where they found that the 30day and 1-year survival rates were significantly higher among patients undergoing immediate coronary angiography compared to patients on whom immediate coronary angiography was not performed (221/370 (59.7%) vs. 30/131 (22.9%), p = 0.001) and that in patients on whom immediate coronary angiography was performed, a good neurologic outcome at discharge, defined as CPC 1 or 2, was achieved in 164/299 (54.8%) [12]. This is a very important finding since the benefit of early revascularization has been proven in patients with STEMI, while diagnostic pathways remain unclear in the absence of STEMI.…”

Section: Discussionmentioning

confidence: 93%

Survival and neurologic recovery after out-of-hospital cardiac arrest

Jaraković¹,

Aleksić²,

Bjelica³

et al. 2022

Halo 194

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Introduction/Objective: Survival and neurologic recovery after out-of-hospital cardiac arrest remain poor despite significant advances in the therapeutic approach. The study aimed to evaluate predictors of intrahospital survival and neurologic outcome among patients after outof-hospital cardiac arrest as well as to evaluate the influence of mild therapeutic hypothermia introduction on intrahospital survival and neurologic outcome among comatose patients after out-of-hospital cardiac arrest. Methods The research was conducted as a retrospective observational study among patients hospitalized at the Cardiac Intensive Care Unit of the Institute for Cardiovascular Diseases of Vojvodina from January 2007 until November 2019 as a result of an out-of-hospital cardiac arrest. Results. The research included 506 survivors of OHCA. Multivariate regression analysis showed that initial shockable rhythm, cardiopulmonary resuscitation efforts lasting no longer than 20 minutes and a Glasgow Coma Score above 8 at admission, were predictors of intrahospital survival and good neurological outcome. Introduction of mild therapeutic hypothermia improved intrahospital survival (54.1% vs. 24.4%; p < 0.0005) and neurological outcome (42.9% vs. 18.3%; p < 0.0005) in comatose patients with initial shockable rhythm. Conclusion. In our study group of out-of-hospital cardiac arrest patients, initial shockable rhythm, cardiopulmonary resuscitation efforts lasting no longer than 20min and a Glasgow Coma Score above 8 at admission were predictors of intrahospital survival and favourable neurological outcome. The introduction of mild therapeutic hypothermia significantly improved survival and neurological outcomes in comatose patients with initial shockable rhythms.

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Section: Discussionmentioning

confidence: 93%

Survival and neurologic recovery after out-of-hospital cardiac arrest

Jaraković¹,

Aleksić²,

Bjelica³

et al. 2022

Halo 194

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“… 1 Extensive research has been conducted on factors associated with short-term survival following OHCA. 9 , 10 , 11 Recently, however, increased focus has been placed on the long-term outcomes of OHCA, 12 , 13 , 14 including long-term survival and health-related quality of life during the additional years of life lived, 12 , 15 , 16 , 17 which help evaluate the natural history and long-term impact of OHCA on the health burden of society. 12 , 18 , 19 To quantify both the fatal and non-fatal disease burden of OHCA, several recent articles had applied the concept of disability-adjusted life years (DALYs) to OHCA.…”

Section: Introductionmentioning

confidence: 99%

Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort study

Lim²,

Earnest³

et al. 2023

The Lancet Regional Health - Western Pacific

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Section: Introductionmentioning

confidence: 99%

“…6,7 Although most research on cardiac arrest (CA) emphasizes situational differences such as witnessed arrest, bystander cardiopulmonary resuscitation, or shockable cardiac rhythm, little has been investigated into the relationship between prognoses and biomarkers. [8][9][10][11][12] Renal function has been suggested to predict patient outcomes in a few circumstances, including CA and acute coronary syndrome, as chronic kidney disease is notorious for increased cardiovascular risks. 13,14 The blood urea nitrogen (BUN) to creatinine (Cr) ratio (BCR) is a promising indicator reflecting more than patient fluid or nutritional status.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of the blood urea nitrogen to creatinine ratio in in-hospital cardiac arrest after targeted temperature management

Meng

Hou

et al. 2022

Journal of the Chinese Medical Association

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Background: Targeted temperature management (TTM) has been reported to improve outcomes in in-hospital cardiac arrest (IHCA) patients but little has been investigated into the relationship between prognoses and the blood urea nitrogen to creatinine ratio (BCR). Methods: A retrospective analysis of data from IHCA survivors treated with TTM between 2011 and 2018 was conducted based on the Research Patient Database Registry of the Partners HealthCare system in Boston. Serum laboratory data were measured during IHCA and within 24 hours after TTM completion. Intra-arrest and post-TTM BCRs were calculated, respectively. The primary outcome was neurologic status at discharge. The secondary outcome was in-hospital mortality. Results: The study included 84 patients; 63 (75%) were discharged with a poor neurologic status and 40 (47.6%) died. Regarding poor neurological outcome at discharge, multivariate analysis revealed that post-TTM BCR was a significant predictor (adjusted OR, 1.081; 95% CI, 1.002–1.165; p = 0.043) and intra-arrest BCR was a marginal predictor (adjusted OR, 1.067; 95% CI, 1.000–1.138; p = 0.050). Post-TTM BCR had an acceptably predictive ability to discriminate neurological status at discharge, with an area under the receiver-operating characteristic curve of 0.644 (95% CI, 0.516–0.773) and a post-TTM BCR cutoff value of 16.7 had a sensitivity of 61.9% and a specificity of 70.0%. Conclusion: Post-TTM BCR was a significant predictor of the neurologic outcome at discharge among IHCA patients receiving TTM. IHCA patients with elevated intra-arrest BCR also had a borderline poor neurological prognosis at discharge.

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Predicting factors for long-term survival in patients with out-of-hospital cardiac arrest – A propensity score-matched analysis

Cited by 10 publications

References 29 publications

Survival and neurologic recovery after out-of-hospital cardiac arrest

Survival and neurologic recovery after out-of-hospital cardiac arrest

Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort study

Prognostic significance of the blood urea nitrogen to creatinine ratio in in-hospital cardiac arrest after targeted temperature management

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