Long term clinical outcomes in survivors after out-of-hospital cardiac arrest

Rey, J.; Caro‐Codón, Juan; Sotelo, L Rodriguez; López-de-Sá, Esteban; Rosillo, Sandra; Fernández, Óscar González; Bobadilla, Jaime Fernández de; Iniesta, Ángel M.; Conde, Laura; Miranda, Isabel Antorrena; Armada, Eduardo; Cantador, José Ruiz; López‐Sendón, José

doi:10.1016/j.ejim.2019.11.024

Cited by 21 publications

(22 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This evidence stresses both the importance of a long-term follow-up of OHCA patients to better comprehend the long-term issues of survivors and the utility to use the subgroups of patients suggested by Utstein to also evaluate the long-term outcome. This is also reinforced considering that, in our analysis, we highlighted a similar trend in SMR considering the patients discharged alive with a good neurological outcome (CPC 1 or 2), so excluding those patients with a CPC of 3 or 4 at discharge, which is a recognized predictor of mortality during follow-up ( 30 ). The higher mortality risk compared to the general population emphasizes the need both of future research focus on this specific topic to comprehend the reasons for a higher SMR in patients discharged with a good neurological outcome and of strictly monitoring the OHCA patients discharged alive, regardless of the neurological outcome, to prevent possible future complications and early death in the follow-up.…”

Section: Discussionsupporting

confidence: 70%

“…Another study from the 1900's in the U.S. highlighted a better survival in patients aged 65 or less, with a long-term survival similar to the general population, but they included only the patients with first shockable presenting rhythm who received rapid defibrillation ( 29 ). Selection was also biased in a recent study from Spain ( 30 ), where only patients admitted alive in the Acute Cardiac Care Unit were included. Significant morbidities and mortality were observed in the short- and long-term period in this cohort of patients, identifying a negative neurological outcome at discharge, a non-shockable presenting rhythm, a long collapse to resuscitation time, age, and a low ejection fraction at discharge as predictors of a worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Baldi

Compagnoni

Buratti

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

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

Baldi

Compagnoni

Buratti

et al. 2021

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…As a result of the increase in the rate of good prognosis of OHCA patients, the long-term effects in surviving patients would be increased. Surviving patients could develop neurological sequelae caused by both initial anoxia and subsequent ischaemia-reperfusion injury, and such sequelae could affect their physical, cognitive, and psychosocial characteristics [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Association of depression with long-term mortality in survivors of out-of-hospital cardiac arrest: A population-based longitudinal study

Lee

Cho

et al. 2022

Preprint

View full text Add to dashboard Cite

Background: We aimed to identify the associations between depression or anxiety and long-term mortality in survivors of out-of-hospital cardiac arrest (OHCA). Methods: We conducted a retrospective longitudinal cohort study using claims data from the Korean National Health Insurance Service (NHIS) database. We included OHCA patients (aged ≥18 years) who werehospitalized between January 2005 and December 2015 and had survived for 1 year or longer. We extracted the data of patients diagnosed with depression or anxiety within l year. The endpoint waslong-term cumulative mortality. We evaluated long-term mortality in patients with and withouta diagnosis of depression or anxiety. Results: We followed 2,373 OHCA patients for up to 14 years. A total of 397 (16.7%) patients were diagnosed with depression or anxiety, of whom251 (10.6%) and 227 (9.6%) were diagnosed with depression and anxiety, respectively. The incidence of long-term mortality was significantly higher in the group diagnosed with depression or anxiety than in the group without depression or anxiety [141 (35.5%) vs. 534 (27.0%), p=0.001]. We performed multivariate Cox proportional hazards regression,and the adjusted hazard ratios (aHRs) of long-term mortality in total patients with depression or anxiety, patients with depression, and patients with anxiety were 1.41 (95% confidence interval (CI), 1.17-1.70), 1.44 (95% CI, 1.16-1.79), and 1.20 (95% CI, 0.94-1.53), respectively. Conclusions: Among the patients who survived OHCA, those diagnosed with depression or anxiety had higher long-term mortality rates than those without depression or anxiety.

show abstract

“…1 Although timely and advanced emergency aid helps to improve the probability of return of spontaneous circulation (ROSC) and subsequent survival, only about 9% of OHCA patients achieve good neurological function at discharge. 1 Notably, survivors with good neurological function can still suffer from cognitive impairment 2 and encounter problems while returning to work. 3 Currently, targeted temperature management (TTM), previously called therapeutic hypothermia, is the sole intervention for improving neurological outcomes in the post-ROSC phase of care.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Targeted temperature management and early neuro-prognostication after cardiac arrest

Chen

Lachance

Gao

et al. 2021

J Cereb Blood Flow Metab

View full text Add to dashboard Cite

Targeted temperature management (TTM) is a recommended neuroprotective intervention for coma after out-of-hospital cardiac arrest (OHCA). However, controversies exist concerning the proper implementation and overall efficacy of post-CA TTM, particularly related to optimal timing and depth of TTM and cooling methods. A review of the literature finds that optimizing and individualizing TTM remains an open question requiring further clinical investigation. This paper will summarize the preclinical and clinical trial data to-date, current recommendations, and future directions of this therapy, including new cooling methods under investigation. For now, early induction, maintenance for at least 24 hours, and slow rewarming utilizing endovascular methods may be preferred. Moreover, timely and accurate neuro-prognostication is valuable for guiding ethical and cost-effective management of post-CA coma. Current evidence for early neuro-prognostication after TTM suggests that a combination of initial prediction models, biomarkers, neuroimaging, and electrophysiological methods is the optimal strategy in predicting neurological functional outcomes.

show abstract

Long term clinical outcomes in survivors after out-of-hospital cardiac arrest

Cited by 21 publications

References 23 publications

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

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

Association of depression with long-term mortality in survivors of out-of-hospital cardiac arrest: A population-based longitudinal study

Targeted temperature management and early neuro-prognostication after cardiac arrest

Contact Info

Product

Resources

About