Determinants of unfavorable prognosis for out-of-hospital sudden cardiac arrest in Bielsko-Biala district

Abstract

IntroductionThe prognosis in out-of-hospital sudden cardiac arrest (OHCA) remains unfavorable and depends on a number of demographic and clinical variables, the reversibility of its causes and its mechanisms.AimTo investigate the risk factors of prehospital death in patients with OHCA in Bielsko County.Material and methodsThe study analyzed all dispatch cards of the National Emergency Medical Services (EMS) teams in Bielsko-Biala for the year 2013 (n = 23 400). Only the cards related to sudden cardiac arrest in adults were ultimately included in the study (n = 272; 190 men, 82 women; median age: 71 years).ResultsSixty-seven victims (45 men, 22 women) were pronounced dead upon the arrival of the EMS team, and cardiopulmonary resuscitation (CPR) was not undertaken. In the remaining group of 205 subjects, CPR was commenced but was ineffective in 141 patients (97 male, 44 female). Although univariate analysis indicated 6 predictors of prehospital death, including OHCA without the presence of witnesses (odds ratio (OR) = 4.2), OHCA occurring in a public place (OR = 3.1), no bystander CPR (OR = 9.7), no bystander cardiac massage (OR = 13.1), initial diagnosis of non-shockable cardiac rhythm (OR = 7.0), and the amount of drugs used for CPR (OR = 0.4), logistic regression confirmed that only the lack of bystander cardiac massage (OR = 6.5) and non-shockable rhythm (OR = 4.6) were independent determinants of prehospital death (area under ROC curve = 0.801).ConclusionsNon-shockable rhythm of cardiac arrest and lack of bystander cardiac massage are independent determinants of prehospital death in Bielsko-Biala inhabitants suffering from OHCA.

Predicting survival in out-of-hospital cardiac arrest patients undergoing targeted temperature management: The Polish Hypothermia Registry Risk Score

“…Wibrandt et al [6] reported that VT/VF as initial rhythm, the cardiac etiology of OHCA and time to ROSC < 20 min were strong predictors of both survival and favourable neurological outcomes. In a recent Polish study on pre-hospital death predictors in OHCA victims, Gach et al [9] reported that univariate analysis indicated 6 predictors of death: OHCA without witnesses, OHCA in a public place, no bystander CPR, no bystander cardiac massage, initial diagnosis of non-shockable cardiac rhythm and the amount of drugs used for CPR. However, logistic regression confirmed that only the lack of bystander cardiac massage and non-shockable…”

“…Sensitivity rhythm were independent determinants of prehospital death [9]. Among other recent reports, Aldhoon et al [10] examined the factors affecting 1-month outcomes in 46 OHCA survivors treated with hypothermia.…”

Epidemiology, management, and survival rate of out-of-hospital cardiac arrest in Upper Silesia, Poland: an Utstein-style report

“…Recent registry-based studies provided much data on epidemiology, characteristics, and prehospital outcomes of patients with OHCA in Poland [2][3][4][5][6][7][11][12][13][14][15][16][17]. Howev-Table III.…”

“…In recent years the number of studies on the epidemiology of OHCA in Poland has multiplied [2][3][4][5][6][7]. These studies have yielded a large amount of information on the incidence rate of OHCA and prehospital outcomes in the Polish population.…”

Clinical prognostication of out-of-hospital cardiac arrest: insight from a prospective observational study using the shockable, witnessed, age and pH score

“…The analysis revealed that patients with favorable outcomes (CPC 1 and 2) had an average SWAP score of 1, while patients with unfavorable outcomes (CPC 3, 4, 5) had an average SWAP score of 1.55. Among the total of 116 patients, 7 individuals (6.03%) survived with positive neurological outcomes (CPC 1 and 2), while 109 patients (93.96%) experienced poor neurological outcomes (CPC 3,4,5, and mortality). Conclusions: Patients who had a high SWAP score had a reduced likelihood of survival and sustained ROSC.…”