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Long-Term Outcome After Out-of-Hospital Cardiac Arrest: An Utstein-Based Analysis

Authors :
Enrico Baldi
Sara Compagnoni
Stefano Buratti
Roberto Primi
Sara Bendotti
Alessia Currao
Francesca Romana Gentile
Giuseppe Maria Sechi
Claudio Mare
Roberta Bertona
Irene Raimondi Cominesi
Erika Taravelli
Cristian Fava
Gian Battista Danzi
Luigi Oltrona Visconti
Simone Savastano
all the Lombardia CARe Researchers
Guido Francesco Villa
Guido Matiz
Maurizio Migliori
Andrea Pagliosa
Fabrizio Canevari
Antonella Brancaglione
Alessandra Palo
Enrico Contri
Vincenza Ronchi
Antonella De Pirro
Simone Molinari
Vito Sgromo
Martina Paglino
Francesco Mojoli
Moreno Curti
Catherine Klersy
Valeria Musella
Livio Carnevale
Arianna Marioni
Giuseppe Bergamini
Francesca Reali
Ugo Rizzi
Daniele Bussi
Simone Ruggeri
Luigi Moschini
Laura Zanotti
Enrico Storti
Pierpaolo Parogni
Fabio Facchin
Giovanni Buetto
Mario Luppi
Dario Franchi
Matteo Caresani
Sabina Campi
Paola Centineo
Roberto De Ponti
Alessandra Russo
Andrea Lorenzo Vecchi
Cecilia Fantoni
Cinzia Franzosi
Claudio Vimercati
Fulvio Giovenzana
Salvatore Ivan Caico
Paola Genoni
Battistina Castiglioni
Marco Botteri
Giovanna Perone
Gianluca Panni
Luca Bettari
Daniele Ghiraldin
Diego Maffeo
Marco Paiella
Umberto Piccolo
Marco Cazzaniga
Ilaria Passarelli
Source :
Frontiers in Cardiovascular Medicine, Vol 8 (2021)
Publication Year :
2021
Publisher :
Frontiers Media S.A., 2021.

Abstract

Background: No data are available regarding long-term survival of out-of-hospital cardiac arrest (OHCA) patients based on different Utstein subgroups, which are expected to significantly differ in terms of survival. We aimed to provide the first long-term survival analysis of OHCA patients divided according to Utstein categories.Methods: We analyzed all the 4,924 OHCA cases prospectively enrolled in the Lombardia Cardiac Arrest Registry (Lombardia CARe) from 2015 to 2019. Pre-hospital data, survival, and cerebral performance category score (CPC) at 1, 6, and 12 months and then every year up to 5 years after the event were analyzed for each patient.Results: A decrease in survival was observed during the follow-up in all the Utstein categories. The risk of death of the “all-EMS treated” group exceeded the general population for all the years of follow-up with standardized mortality ratios (SMRs) of 23 (95%CI, 16.8–30.2), 6.8 (95%CI, 3.8–10.7), 3.8 (95%CI, 1.7–6.7), 4.05 (95%CI, 1.9–6.9), and 2.6 (95%CI, 1.03–4.8) from the first to the fifth year of follow-up. The risk of death was higher also for the Utstein categories “shockable bystander witnessed” and “shockable bystander CPR”: SMRs of 19.4 (95%CI, 11.3–29.8) and 19.4 (95%CI, 10.8–30.6) for the first year and of 6.8 (95%CI, 6.6–13) and 8.1 (95%CI, 3.1–15.3) for the second one, respectively. Similar results were observed considering the patients discharged with a CPC of 1–2.Conclusions: The mortality of OHCA patients discharged alive from the hospital is higher than the Italian standard population, also considering those with the most favorable OHCA characteristics and those discharged with good neurological outcome. Long-term follow-up should be included in the next Utstein-style revision.

Details

Language :
English
ISSN :
2297055X
Volume :
8
Database :
Directory of Open Access Journals
Journal :
Frontiers in Cardiovascular Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.14cc50d4f44b4b0fb7ec890084c9b4ba
Document Type :
article
Full Text :
https://doi.org/10.3389/fcvm.2021.764043