Pulseless electrical activity and unsuccessful out-of-hospital resuscitation: What is the cause of death?

Virkkunen, Ilkka; Paasio, Laura; Ryynänen, Sanna; Vuori, Arno; Sajantila, Antti; Yli‐Hankala, Arvi; Silfvast, Tom

doi:10.1016/j.resuscitation.2007.12.006

Cited by 47 publications

(19 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This percentage is exceptionally high as compared to other aetiologycal studies and autopsy after an unsuccessful resuscitation attempt has been suggested as 'golden standard' for studies on the cause of cardiac arrest. 26,27 We used age-adjusted charlson comorbidity index as a continuous variable to take into consideration the possible negative effect of cumulative age-related comorbidity in our analyses. 24 Third, despite a single centre design, TAYS is one of the five tertiary referral centres in Finland providing the most advanced care and the general wards represent all major specialties and our study population was very heterogeneous.…”

Section: Discussionmentioning

confidence: 99%

Aetiology of in-hospital cardiac arrest on general wards

et al. 2016

View full text Add to dashboard Cite

a b s t r a c tAim: Aetiology of in-hospital cardiac arrests (IHCAs) on general wards has not been studied. We aimed to determine the underlying causes for IHCAs by the means of autopsy records and clinical judgement of the treating consultants. Furthermore, we investigated whether aetiology and preceding vital dysfunctions are associated with long-term survival. Design and setting: Prospective observational study between 2009-2011 including 279 adult IHCA patients attended by medical emergency team in a Finnish university hospital's general wards. Results: The median age of the patients was 72 (64, 80) years, 185 (66%) were male, 178 (64%) of events were monitored/witnessed, first rhythm was shockable in 42 (15%) cases and 53 (19%) patients survived six months. Aetiology was determined as cardiac in 141 events, 73 of which were due to acute myocardial infarction. There were 138 non-cardiac IHCAs; most common causes were pneumonia (39) and exsanguination (16). No statistical difference was observed in the incidence of objective vital dysfunctions preceding the event between the cardiac and non-cardiac groups (40% vs. 44%, p = 0.448). Subjective antecedents were more common in the cardiac cohort (47% vs. 32%, p = 0.022), chest pain being an example (11% vs. 0.7%, p < 0.001). Reviewing all 279 IHCAs, only shockable primary rhythm, monitored/witnessed event and low comorbidity score were independently associated with 180-day survival. Conclusions: Cardiac aetiology underlies half of the IHCAs on general wards. Both objective and subjective antecedents are common. However, neither the cardiac aetiology nor the absence of preceding deterioration of vital signs were factors independently associated with a favourable outcome.

show abstract

Section: Discussionmentioning

confidence: 99%

Aetiology of in-hospital cardiac arrest on general wards

et al. 2016

View full text Add to dashboard Cite

show abstract

“…When initial rhythm was shockable, in contrast, neither the ROSC rate nor survival rate differed significantly between the LOC and CP subsets, although the rates seemed to be elevated in the former. It is known that non-shockable OHCA may be more heterogeneous in aetiology compared with shockable OHCA 10 11. The above finding may make sense if we assume that the LOC-NS subset consisted of a higher percentage of non-cardiac OHCA compared with the CP-NS subset: for example, patients with a SAH, who tend to show a high ROSC rate and initial non-shockable rhythm, often present with LOC alone 12.…”

Section: Discussionmentioning

confidence: 92%

Prognostic significance of acute pain preceding out-of-hospital cardiac arrest

Inamasu

Tomioka²,

Shirai³

et al. 2010

Emergency Medicine Journal

View full text Add to dashboard Cite

show abstract

“…First, data on in-hospital CPR after hospital arrival were not included in analyses. It is possible that our findings may have been due to a difference in in-hospital resuscitation, such as hypothermia [40] and mechanical chest compression devices [41], among the LR solution and no-LR solution groups. Although the quality of in-hospital resuscitation might influence 1-month survival, we could not control for the effects of such factors.…”

Section: Discussionmentioning

confidence: 94%