Intrahospital survival and neurological recovery after out of hospital cardiac arrest

Abstract

Introduction. Despite advances in therapeutical approach, survival and neurological recovery after out-of-hospital cardiac arrest still remain poor.

Aim. The aim of the study was to evaluate predictors of intrahospital survival and neurological outcome among patients after out-of-hospital cardiac arrest and to evaluate influence of introduction of mild therapeutic hypothermia on intrahospital survival and neurological outcome among comatose patients after out-of-hospital cardiac arrest.

Methods. The research was conducted as a retrospective observational analysis of the sample of patients hospitalized at the Cardiac Intensive Care Unit of the Institute of Cardiovascular Diseases of Vojvodina from January 2007 until November 2019 due to out-of-hospital cardiac arrest. Statistical analysis was performed using SPSS 17 statistical package.

Results. The research included 506 survivors of OHCA. Multivariate regression analysis showed that: initial shockable rhythm (OR 3.301[2.002 - 5.441], p < 0.0005), duration of cardiopulmonary resuscitation ≤20 min (OR 5.144 [3.090 - 8.565], p < 0.0005) and Glasgow Coma Score >8 at admission (OR 0.152 [0.088 - 0.260], p < 0.0005) 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, duration of cardiopulmonary resuscitation ≥ 20min and Glasgow Coma Score >8 at admission influenced intrahospital survival and favorable neurological outcome. Introduction of mild therapeutic hypothermia significantly improved survival and neurological outcome in comatose patients with initial shockable rhythm.