Effect of hypertension across the age group on survival outcomes in out-of-hospital cardiac arrest

Jung, Eujene; Park, Jeong Ho; Ro, Young Sun; Song, Kyoung Jun; Ryu, Hyun Ho; Lee, Seung−Chul; Shin, Sang Do

doi:10.1016/j.ajem.2018.06.049

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…However, previous studies have also claimed that hypertension had a good survival outcome in univariable analysis 44 – 46 . In addition, another recent study has shown similar outcomes in univariable and multivariable analyses 47 . While this study could not fully explain why hypertension had a favourable effect on outcomes after OHCA, the authors explained that the result might come from the pathophysiology of hypertension itself or lifestyle changes and medication after the patient’s diagnosis of hypertension.…”

Section: Discussionmentioning

confidence: 75%

The interaction effect of bystander cardiopulmonary resuscitation (CPR) and dispatcher CPR on outcomes after out-of-hospital cardiac arrest

Sohn

Cho

2022

Sci Rep

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This study aimed to evaluate the effects of bystander cardiopulmonary resuscitation (CPR) and dispatcher-assisted CPR (DA-CPR) on outcomes after out-of-hospital cardiac arrest (OHCA). We conducted a prospective observational study using the Korean Cardiac Arrest Research Consortium registry database and enrolled adults aged > 20 years who sustained OHCA. The study population comprised 13,864 patients from October 1, 2015, to June 30, 2021. All enrolled patients were transported to the emergency room and resuscitated by the emergency medical personnel. Patients with terminal illnesses, pregnancy, “do not resuscitate” cards, and insufficient recorded information were excluded. Good neurologic outcomes were noted in 6.5%, 9.9%, and 9.6% of patients in the “no bystander”, “standard bystander”, and “compression-only bystander” CPR groups, respectively, and differed significantly (p < 0.001). Survival to discharge differed significantly (p < 0.001) between groups at 10.8%, 13.1%, and 13.2%, respectively. In a multivariable model, the interaction between “compression-only” and DA-CPR showed a positive effect on good neurological outcomes and survival to discharge with an odds ratio of 1.93 (Confidence interval, CI 1.28–2.91, p = 0.002) and 1.74 (CI 1.24–2.44, p = 0.001), respectively. In conclusion, the interaction between compression-only CPR and DA-CPR is significantly associated with good neurological and survival outcomes after OHCA. Education for bystanders and dispatchers should adhere to the current guidelines to improve outcomes among OHCA victims.

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Section: Discussionmentioning

confidence: 75%

The interaction effect of bystander cardiopulmonary resuscitation (CPR) and dispatcher CPR on outcomes after out-of-hospital cardiac arrest

Sohn

Cho

2022

Sci Rep

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“…In the subgroup analysis,Our subgroup analysis revealed that the association between ALP and risk of UNO in 3 months existed between the layers except hypertension.It showed that ALP concentration was positively associated with UNO in 3 months in nonhypertension (OR 1.018(1.0041,1.032)), P for trend 0.01083)However, the associations were not observed in hypertensions.The reasons for the unclear relationship between ALP and the adverse outcome in the hypertension group were unclear.It has been proposed that there are various complications in patients with hypertension, so TTM is associated with good neurological recovery in patients without hypertension, but not in patients with hypertension 27,28 .Eujene Jung suggests that hypertension does not have an adverse effect on the prognosis of patients with cardiac arrest 27 .This may be associated with hypertension patients with greater awareness of activating emergency medical services (EMS) with ischemic symptoms.And lead to short cardiac arrest to EMS recovery 29 .Another possibility is that the effects of hypertension drugs can be taken into account.There have been studies that calcium channel blockers can be treated in ischemic pretreatment reserved with cardiac arrest and angiotensin converting enzyme inhibitors to reduce recurrent myocardial infarction and ischemia 30,31 .In addition, most patients with hypertension have cerebrovascular sclerosis, which involves too many diseases 32 .In the future, it is necessary to study the factors related to HTN which improve the favorable neurological outcome of CA patients.…”

Section: Discussionmentioning

confidence: 99%

The Association Between Alkaline Phosphatase and Neurological Outcome in Patients with Post-cardiac Arrest: a Secondary Analysis of Data from Belgium

he¹

2021

Preprint

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Background: Prognostication of the unfavourable neurological outcome(UNO) after Cardiac arrest(CA) is multimodal while blood biomarkers are an attractive option.Serum alkaline phosphatase(ALP) is shown to be associated with ischemic stroke and considered as an independent prognostic factor for long-term functional outcome after acute cerebral infarction.We aimed to study the association between ALP and UNO in 3 months in patients after CA.Methods:Review of consecutive patients admitted to the ICU at Erasme Hospital, Brussels (Belgium) following CA between January 2007 and December 2015. The outcome was the UNO in 3 months. We used multivariable logistic regression models to calculate the adjusted odd ratio (OR) with 95% confidence interval(CI). Interaction and stratified analyses were conducted according to Shock,Dobutamine.used,Hypertension,Cardiac.Etiology and Shockable.Rhythm.Results: We included 374 CA patients. The multivariate logistic regression analyses revealed that the risk of UNO in 3 months after CA was significantly associated with ALP.When ALP was Equal is divided in 3 groups, the risk of ALP>91 level and adverse outcomes was 1.7407 times of ALP<64 level (P for trend=0.19709).In the non-hypertension group, the risk of adverse outcomes increased with increased ALP by 1.018 (1.0041.01,1.032).Conclusions: ALP is an independent risk factor for the UNO in 3 months after CA, especially in non-hypertension. Elevated ALP was significantly associated with increased UNO in 3 months after CA. However, the prediction significance of ALP for long-term neurological outcome in patients after CA is needed further studied.

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“…Monthly QMC meetings provided feedback to all medical record reviewers to ensure data quality. [ 17 , 18 ]…”

Section: Methodsmentioning

confidence: 99%

Association between scene time interval and clinical outcomes according to key Utstein factors in out-of-hospital cardiac arrest

Jung

Ryu

et al. 2022

Medicine

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There is no consensus on the appropriate length of time spent on the scene by emergency medical services. Hence, our study aimed to investigate the association between the scene time interval (STI) and clinical outcomes of out-of-hospital cardiac arrest (OHCA) and determine whether this association is affected by key Utstein factors—witness status, bystander cardiopulmonary resuscitation, and initial electrocardiogram rhythm. This study is a cross-sectional study, using data between 2017 and 2020 from a nationwide, population-based, prospective registry of OHCA. The primary exposure is the STI, which was categorized into 3 groups: short (0 < STI ≤ 12 min), middle (13 ≤ STI ≤ 16 min), long (17 ≤ STI ≤ 30 min). The main outcome was good neurological recovery. Multivariable logistic regression and interaction analyses were performed to estimate the effect of STIs on study outcomes according to key Utstein factors. Witnessed, bystander cardiopulmonary resuscitation, and an initial shockable rhythm were associated with high survival to discharge and good neurological recovery, whereas prolonged STI was associated with low survival to discharge and poor neurological recovery. In patients with witnessed arrest, increased STI caused a more rapid decrease in survival to discharge than in non-witnessed cases (witnessed arrest: 0.56 (0.51–0.62) in middle STI and 0.33 (0.30–0.37) in long STI, non-witnessed arrest: 0.72 (0.61–0.85) in middle STI and 0.53 (0.45–0.62) in long STI. In patients with an initial shockable rhythm, increased STI caused a more rapid decrease in survival to discharge and neurological recovery than in initial non-shockable cases. Longer STIs were associated with poorer OHCA outcomes, and this trend was further emphasized in patients with witnessed OHCA and OHCA with an initial shockable rhythm.

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Effect of hypertension across the age group on survival outcomes in out-of-hospital cardiac arrest

Cited by 5 publications

References 26 publications

The interaction effect of bystander cardiopulmonary resuscitation (CPR) and dispatcher CPR on outcomes after out-of-hospital cardiac arrest

The interaction effect of bystander cardiopulmonary resuscitation (CPR) and dispatcher CPR on outcomes after out-of-hospital cardiac arrest

The Association Between Alkaline Phosphatase and Neurological Outcome in Patients with Post-cardiac Arrest: a Secondary Analysis of Data from Belgium

Association between scene time interval and clinical outcomes according to key Utstein factors in out-of-hospital cardiac arrest

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