Long-term mortality among patients discharged alive after out-of-hospital cardiac arrest does not differ markedly compared with that of myocardial infarct patients without out-of-hospital cardiac arrest

Abstract

The aim of our research was to study the long-term prognosis among patients discharged alive after an out-of-hospital cardiac arrest (OHCA) in comparison with patients discharged alive after acute myocardial infarction (AMI) without OHCA, and also to study the long-term influence of AMI in connection with OHCA. Our research was conducted in the municipality of Göteborg. We retrospectively studied patients discharged from hospital 1990-91 after an OHCA of cardiac aetiology and patients discharged after an AMI without prehospital cardiac arrest. During 1980-98, we studied all patients discharged alive after OHCA of cardiac aetiology, divided into groups of precipitating AMI and no AMI. The study includes 48 patients discharged alive after an OHCA 1990-91, 30 (62%) of whom had a simultaneous AMI and 1425 patients with an AMI without OHCA. Compared with AMI survivors, survivors of an OHCA of cardiac origin were younger but had more frequently a history of congestive heart failure. Their mortality rate during the subsequent 5 years was 46%, compared with 40% among survivors of an AMI (NS). The 5-year mortality rate among patients with an OHCA precipitated by an AMI was 40%. When correcting for differences at baseline, the adjusted risk ratio for death among patients with an OHCA of cardiac origin was 1.2 (95% CI 0.8-1.8) compared with patients with an uncomplicated AMI. During 1980-98, 215 patients were judged as having an OHCA precipitated by an AMI and 115 patients had an OHCA of cardiac aetiology but no simultaneous AMI. Five-year mortality was 54% and 50% respectively (NS). It is concluded that survivors of an OHCA of cardiac origin differed from survivors of an uncomplicated AMI in that they were younger and more frequently had a history of cardiovascular disease. Their 5-year mortality after discharge was similar to that of survivors of an AMI without a prehospital cardiac arrest, even after adjusting for differences at baseline.

Long-term survival after successful inhospital cardiac arrest resuscitation

“…23 The mortality rate of arrest survivors in our study was comparable to that of out-of-hospital cardiac arrest patients. [24][25][26][27][28][29] In the case of out-of-hospital cardiac arrest survivors, ICD implantation is a highly effective secondary prevention strategy for this high-risk group. Our data suggest that a similar strategy may be effective for inhospital arrest survivors.…”

A seven-year follow-up of discharged patients after out-of-hospital cardiac arrest with respect to ST-segment elevation myocardial infarction

“…survival in 53 patients, from discharge after OHCA of "primary cardiac" aetiology, between 2002 to 2004. In comparison with the reference literature, we demonstrated that the initial numbers of patients sampled ranged from 48 to 95 patients, (4,11,16,19,20) and 139 to 680 patients. (1,2,5,7,17,(21)(22)(23) Most of these studies are however retrospective in nature with data obtained from central registers.…”

“…consider it important, for the accuracy of clinical status of the patient, to evaluate the physician's long-term contact with the patient from the institution of CPR in the field to outpatient follow-up. Geographically, long-term studies include localities mainly in the United States of America and Europe (Denmark, Sweden, Norway, Estonia, the Netherlands, Scotland and Northern Ireland) (3)(4)(5)9,11,(16)(17)(18)(19). Data for our study were obtained from the region of East Bohemia in the Czech Republic.…”

“…(7) The long-term prognosis of patients discharged from hospital is mainly influenced by diagnostic and therapeutic measures undertaken during acute hospitalization and during subsequent long-term follow-up. (2,3,11,17,24) P value, Fisher's exact test in contingency tables. …”

“…Comparison of survival in these patients with patients with STEMI without OHCA, and even with the normal population, shows no obvious differences in survival. (8)(9)(10)(11)(12) The aim of our study was to describe the seven-year survival in patients from the region of East Bohemia discharged after acute hospitalization for "primary cardiac" OHCA, mainly focusing on the survival of patients with STEMI. Definition STEMI is defined as dynamic elevation of ST-segments on the electrocardiogram (at the J point with the cut-off points ě0.2mV in V 1 through V 3 and ě0.1mV in other leads) along with a typical rise (minimally three times greater than the upper limit of normal values), followed by a fall in biochemical markers of myocardial necrosis [e.g.…”