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The impact of extracerebral organ failure on outcome of patients after cardiac arrest: an observational study from the ICON database

Authors :
Xavier Wittebole
Peter Pickkers
Yasser Sakr
Fabio Silvio Taccone
Tamas Szakmany
Leda Nobile
Marc Leone
Massimo Antonelli
Jean Louis Vincent
Tommaso Pellis
Stephan M. Jakob
Department of Intensive Care and Anesthesiology
Università cattolica del Sacro Cuore [Milano] (Unicatt)
Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE)
Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48
Institut des sciences biologiques (INSB-CNRS)-Institut des sciences biologiques (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)
Université libre de Bruxelles (ULB)
Pilvinis, Vidas
Vosylius, Saulius
Kėkštas, Gintautas
Balčiūnas, Mindaugas
INSB-INSB-Centre National de la Recherche Scientifique (CNRS)
UCL - (SLuc) Service de soins intensifs
UCL - SSS/IREC/MEDA - Pôle de médecine aiguë
Source :
Nobile, Leda; Taccone, Fabio S; Szakmany, Tamas; Sakr, Yasser; Jakob, Stephan; Pellis, Tommaso; Antonelli, Massimo; Leone, Marc; Wittebole, Xavier; Pickkers, Peter; Vincent, Jean-Louis (2016). The impact of extracerebral organ failure on outcome of patients after cardiac arrest: an observational study from the ICON database. Critical care, 20(1), p. 368. BioMed Central 10.1186/s13054-016-1528-6 , Critical Care, 20, 1, pp. 368, Critical Care, Critical Care, 2016, 20, ⟨10.1186/s13054-016-1528-6⟩, Critical care, London, BioMed Central Ltd, 2016, Vol. 20, Art. no 368 [p. 368-375], Critical Care, 20, 368, Critical Care, BioMed Central, 2016, 20, ⟨10.1186/s13054-016-1528-6⟩, Critical care, 20 (1, Critical Care, Vol. 20, no. 1, p. 368 [1-10] (2016)
Publication Year :
2016
Publisher :
BioMed Central, 2016.

Abstract

Background: We used data from a large international database to assess the incidence and impact of extracerebral organ dysfunction on prognosis of patients admitted after cardiac arrest (CA). Methods: This was a sub-analysis of the Intensive Care Over Nations (ICON) database, which contains data from all adult patients admitted to one of 730 participating intensive care units (ICUs) in 84 countries from 8-18 May 2012, except admissions for routine postoperative surveillance. For this analysis, patients admitted after CA (defined as those with "post-anoxic coma" or "cardiac arrest" as the reason for ICU admission) were included. Data were collected daily in the ICU for a maximum of 28 days; patients were followed up for outcome data until death, hospital discharge, or a maximum of 60 days in-hospital. Favorable neurological outcome was defined as alive at hospital discharge with a last available neurological Sequential Organ Failure Assessment (SOFA) subscore of 0-2. Results: Among the 469 patients admitted after CA, 250 (53 %) had had out-of-hospital CA; 210 (45 %) patients died in the ICU and 357 (76 %) had an unfavorable neurological outcome. Non-survivors had a higher incidence of renal (43 vs. 16 %), cardiovascular (56 vs. 45 %), and respiratory (62 vs. 48 %) failure on admission and during the ICU stay than survivors (all p < 0.05). Similar results were found for patients with unfavorable vs. favorable neurological outcomes. In multivariable analysis, independent predictors of ICU mortality were renal failure on admission, high admission Simplified Acute Physiology Score (SAPS) II, high maximum serum lactate levels within the first 24 h after ICU admission, and development of sepsis. Independent predictors of unfavorable neurological outcome were mechanical ventilation on admission, high admission SAPS II score, and neurological dysfunction on admission. Conclusions: In this multicenter cohort, extracerebral organ dysfunction was common in CA patients. Renal failure on admission was the only extracerebral organ dysfunction independently associated with higher ICU mortality.<br />SCOPUS: ar.j<br />info:eu-repo/semantics/published

Details

Language :
English
ISSN :
13648535 and 1466609X
Database :
OpenAIRE
Journal :
Nobile, Leda; Taccone, Fabio S; Szakmany, Tamas; Sakr, Yasser; Jakob, Stephan; Pellis, Tommaso; Antonelli, Massimo; Leone, Marc; Wittebole, Xavier; Pickkers, Peter; Vincent, Jean-Louis (2016). The impact of extracerebral organ failure on outcome of patients after cardiac arrest: an observational study from the ICON database. Critical care, 20(1), p. 368. BioMed Central 10.1186/s13054-016-1528-6 <http://dx.doi.org/10.1186/s13054-016-1528-6>, Critical Care, 20, 1, pp. 368, Critical Care, Critical Care, 2016, 20, ⟨10.1186/s13054-016-1528-6⟩, Critical care, London, BioMed Central Ltd, 2016, Vol. 20, Art. no 368 [p. 368-375], Critical Care, 20, 368, Critical Care, BioMed Central, 2016, 20, ⟨10.1186/s13054-016-1528-6⟩, Critical care, 20 (1, Critical Care, Vol. 20, no. 1, p. 368 [1-10] (2016)
Accession number :
edsair.doi.dedup.....d03b571b82935d91e9b9409761b9f713
Full Text :
https://doi.org/10.1186/s13054-016-1528-6