A predictive model for survival after in-hospital cardiopulmonary arrest

Danciu, Sorin; Klein, Liviu; Hosseini, M.; Ibrahim, Lamiaa; Coyle, Bryan W.; Kehoe, Richard F.

doi:10.1016/j.resuscitation.2004.01.035

Cited by 71 publications

(49 citation statements)

References 19 publications

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“…1,[32][33][34] A greater proportion of patients in the hypothermia therapy group received ECMO. However, no statistical difference was found between the 2 groups relative to hypothermia-related adverse effects or use of inotropes.…”

Section: Discussionmentioning

confidence: 99%

Hypothermia Therapy After Pediatric Cardiac Arrest

et al. 2009

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Background-Hypothermia therapy improves mortality and functional outcome after cardiac arrest and birth asphyxia in adults and newborns. The effect of hypothermia therapy in infants and children with cardiac arrest is unknown. Methods and Results-A 2-year, retrospective, 5-center study was conducted, and 222 patients with cardiac arrest were identified. Seventy-nine (35.6%) of these patients met eligibility criteria for the study (age Ͼ40 weeks postconception and Ͻ18 years, cardiac arrest Ͼ3 minutes in duration, survival for Ն12 hours after return of circulation, and no birth asphyxia). Twenty-nine (36.7%) of these 79 patients received hypothermia therapy and were cooled to 33.7Ϯ1.3°C for 20.8Ϯ11.9 hours. Hypothermia therapy was associated with higher mortality (Pϭ0.009), greater duration of cardiac arrest (Pϭ0.005), more resuscitative interventions (PϽ0.001), higher postresuscitation lactate levels (PϽ0.001), and use of extracorporeal membrane oxygenation (PϽ0.001). When adjustment was made for duration of cardiac arrest, use of extracorporeal membrane oxygenation, and propensity scores by use of a logistic regression model, no statistically significant differences in mortality were found (Pϭ0.502) between patients treated with hypothermia therapy and those treated with normothermia. Also, no differences in hypothermia-related adverse events were found between groups. Conclusions-Hypothermia therapy was used in resuscitation scenarios that are associated with greater risk of poor outcome. In an adjusted analysis, the effectiveness of hypothermia therapy was neither supported nor refuted. A randomized controlled trial is needed to rigorously evaluate the benefits and harms of hypothermia therapy after pediatric cardiac arrest. (Circulation. 2009;119:1492-1500.)

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Section: Discussionmentioning

confidence: 99%

Hypothermia Therapy After Pediatric Cardiac Arrest

et al. 2009

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“…As an outcome prediction model, the incidence of respiratory failure, shockable rhythm, chronic renal insufficiency, body mass index, and the interval from hospitalization to the occurrence of in-hospital CPA have been reported in the literature. 26 In addition, a relationship between the onset time and the outcome has also been reported. 8, 27 In order to construct an outcome prediction model for patients with inhospital CPA, more detailed investigation is required in the future.…”

Section: Outcome Datamentioning

confidence: 98%

Report From the Japanese Registry of CPR for In-Hospital Cardiac Arrest (J-RCPR)

Yokoyama

Yonemoto

Yonezawa

et al. 2011

Circ J

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“…Only 18% of these adults with in-hospital arrests survive to hospital discharge. [1][2][3][4] Although patients surviving to hospital admission after an out-of-hospital cardiac arrest frequently die before hospital discharge because of neurological injury, Ͻ25% of patients with initially successful resuscitation after an inhospital cardiac arrest die as a result of neurological injury. 5 …”

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confidence: 99%

Left Ventricular Systolic Function and Outcome After In-Hospital Cardiac Arrest

et al. 2008

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Background-The effect of prearrest left ventricular ejection fraction (LVEF) on outcome after cardiac arrest is unknown. Methods and Results-During a 26-month period, Utstein-style data were prospectively collected on 800 consecutive inpatient adult index cardiac arrests in an observational, single-center study at a tertiary cardiac care hospital. Prearrest echocardiograms were performed on 613 patients (77%) at 11Ϯ14 days before the cardiac arrest. Outcomes among patients with normal or nearly normal prearrest LVEF (Ն45%) were compared with those of patients with moderate or severe dysfunction (LVEF Ͻ45%) by 2 and logistic regression analyses. Survival to discharge was 19% in patients with normal or nearly normal LVEF compared with 8% in those with moderate or severe dysfunction (adjusted odds ratio, 4.8; 95% confidence interval, 2.3 to 9.9; PϽ0.001) but did not differ with regard to sustained return of spontaneous circulation (59% versus 56%; Pϭ0.468) or 24-hour survival (39% versus 36%; Pϭ0.550). Postarrest echocardiograms were performed on 84 patients within 72 hours after the index cardiac arrest; the LVEF decreased 25% in those with normal or nearly normal prearrest LVEF (60Ϯ9% to 45Ϯ14%; PϽ0.001) and decreased 26% in those with moderate or severe dysfunction (31Ϯ7% to 23Ϯ6%, PϽ0.001). For all patients, prearrest ␤-blocker treatment was associated with higher survival to discharge (33% versus 8%; adjusted odds ratio, 3.9; 95% confidence interval, 1.8 to 8.2; PϽ0.001). Conclusions-Moderate and severe prearrest left ventricular systolic dysfunction was associated with substantially lower rates of survival to hospital discharge compared with normal or nearly normal function.

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A predictive model for survival after in-hospital cardiopulmonary arrest

Cited by 71 publications

References 19 publications

Hypothermia Therapy After Pediatric Cardiac Arrest

Hypothermia Therapy After Pediatric Cardiac Arrest

Report From the Japanese Registry of CPR for In-Hospital Cardiac Arrest (J-RCPR)

Left Ventricular Systolic Function and Outcome After In-Hospital Cardiac Arrest

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