1. Predicting factors for long-term survival in patients with out-of-hospital cardiac arrest – a propensity score-matched analysis
- Author
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Dario Bongiovanni, Adnan Kastrati, Karl-Ludwig Laugwitz, Anna Lena Lahmann, Petra Hoppmann, Heribert Schunkert, Robert A. Byrne, Sebastian Kufner, Rainer Okrojek, Maximilian Kettern, Lucas Martinez, Salvatore Cassese, Michael Joner, Anna Berkefeld, Erion Xhepa, and Markus Kasel
- Subjects
Male ,Multivariate analysis ,Critical Care and Emergency Medicine ,Cardiovascular Procedures ,medicine.medical_treatment ,Coronary Disease ,Cardiovascular Medicine ,Coronary Angiography ,Pathology and Laboratory Medicine ,Vascular Medicine ,Diagnostic Radiology ,Electrocardiography ,Risk Factors ,Germany ,Medicine and Health Sciences ,Cardiac Arrest ,Coronary Heart Disease ,Myocardial infarction ,Registries ,Survivors ,Cardiovascular Imaging ,Radiology and Imaging ,Angiography ,Middle Aged ,Hospitalization ,Bioassays and Physiological Analysis ,Medicine ,Female ,Research Article ,medicine.medical_specialty ,Imaging Techniques ,Science ,Cardiology ,Surgical and Invasive Medical Procedures ,Revascularization ,Research and Analysis Methods ,Out of hospital cardiac arrest ,Percutaneous Coronary Intervention ,Signs and Symptoms ,Diagnostic Medicine ,Internal medicine ,Long term survival ,medicine ,Humans ,In patient ,Propensity Score ,Aged ,Coronary Revascularization ,business.industry ,Electrophysiological Techniques ,Angioplasty ,medicine.disease ,Triage ,Cardiopulmonary Resuscitation ,Propensity score matching ,Lesions ,ST Elevation Myocardial Infarction ,Cardiac Electrophysiology ,business ,Coronary Angioplasty ,Out-of-Hospital Cardiac Arrest - Abstract
BackgroundOut-of-hospital cardiac arrest (OHCA) is one of the leading causes of death worldwide, with acute coronary syndromes accounting for most of the cases.While the benefit of early revascularization has been clearly demonstrated in patients with ST-segment-elevation myocardial infarction (STEMI), diagnostic pathways remain unclear in the absence of STEMI. We aimed to characterize OHCA patients presenting to 2 tertiary cardiology centers and identify predicting factors associated with survival.MethodsWe retrospectively analyzed 519 patients after OHCA from February 2003 to December 2017 at 2 centers in Munich, Germany. Patients undergoing immediate coronary angiography (CAG) were compared to those without. Propensity score (PS) matching analysis and multivariate regression analysis were performed to identify predictors for improved outcome.ResultsImmediate CAG was performed in 385 (74.1%) patients after OHCA with presumed cardiac cause of arrest.As a result of multivariate analysis after propensity score matching, we found that ROSC at admission and immediate CAG were associated with better 30-days-survival [(OR, 6.54; 95% CI, 2.03-21.02), (OR, 2.41; 95% CI, 1.04-5.55)], and 1-year-survival [(OR, 4.49; 95% CI, 1.55-12.98), (OR, 2.54; 95% CI, 1.06-6.09)].ConclusionsIn our study, ROSC at admission and immediate CAG were independent predictors of survival in cardiac arrest survivors. Improvement in prehospital management including bystander CPR and best practice post-resuscitation care with optimized triage of patients to an early invasive strategy may help ameliorate overall outcome of this critically-ill patient population.
- Published
- 2019
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