Long-term survival of out-of-hospital cardiac arrest patients with malignancy

Kang, Saee Byel; Kim, Kyung Soo; Suh, Gil Joon; Kwon, Woon Yong; You, Kyoung Min; Park, Min Ji; Ko, Jung In; Kim, Taegyun

doi:10.1016/j.ajem.2017.04.051

Cited by 14 publications

(25 citation statements)

References 9 publications

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“…Results from each of the individual studies are shown online supplementary table 1 (for survival to hospital discharge outcomes) and online supplementary table 2 (for neurological outcomes). There were 18 studies conducted in Europe,3 5 10 13 15 28–40 four in the USA,8 12 41 42 three in Asia,20 26 43 two multinational studies,11 14 one in Australia9 and one in Canada 44. The number of patients enrolled in each study varied from n=6330 to n=2 47 684 41.…”

Section: Resultsmentioning

confidence: 99%

“…Patient inclusion age varied between studies, with 19 studies restricted to adults (≥16 years),3 8 9 12 20 26 28 29 31 33 36–44 one10 restricted to 70 years or over, seven placing no age restrictions5 11 13 15 32 34 35 and two studies being unclear about age 14 30. Cohort recruitment points varied greatly also, with 15 studies using scene of arrest as the enrolment point,5 8–11 13 20 31–33 38–40 42 44 6 using emergency department (ED) admission12 15 26 35–37 and 8 using hospital admission 3 14 28–30 34 41 43. Cardiac arrest aetiology was identified as either cardiac or non-traumatic in 12 studies,5 8–12 20 26 31 33 36 41 while the remaining studies either placed no restriction or were unclear.…”

Section: Resultsmentioning

confidence: 99%

“…Cohort recruitment points varied greatly also, with 15 studies using scene of arrest as the enrolment point,5 8–11 13 20 31–33 38–40 42 44 6 using emergency department (ED) admission12 15 26 35–37 and 8 using hospital admission 3 14 28–30 34 41 43. Cardiac arrest aetiology was identified as either cardiac or non-traumatic in 12 studies,5 8–12 20 26 31 33 36 41 while the remaining studies either placed no restriction or were unclear. Patient clinical inclusion characteristics were highly variable between the studies.…”

Section: Resultsmentioning

confidence: 99%

“…Where multiple results were reported by a single study for the same exposure but for varying subgroup (for example by initial cardiac arrest rhythm), only one set of results were utilised to prevent duplication. Given the well documented prognostic influence of specific other covariates on OHCA outcomes,4 20 21 adjusted results were preferentially used.…”

Section: Methodsmentioning

confidence: 99%

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Systematic review of the relationship between comorbidity and out-of-hospital cardiac arrest outcomes

2019

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ObjectivesTo assess the current evidence on the effect pre-arrest comorbidity has on survival and neurological outcomes following out-of-hospital cardiac arrest (OHCA).DesignSystematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Data sourcesMEDLINE, Ovid Embase, Scopus, CINAHL, Cochrane Library and MedNar were searched from inception to 31 December 2018.Eligibility criteriaStudies included if they examined the association between prearrest comorbidity and OHCA survival and neurological outcomes in adult or paediatric populations.Data extraction and synthesisData were extracted from individual studies but not pooled due to heterogeneity. Quality of included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale.ResultsThis review included 29 observational studies. There were high levels of clinical heterogeneity between studies with regards to patient recruitment, inclusion criteria, outcome measures and statistical methods used which ultimately resulted in a high risk of bias. Comorbidities reported across the studies were diverse, with some studies reporting individual comorbidities while others reported comorbidity burden using tools like the Charlson Comorbidity Index. Generally, prearrest comorbidity was associated with both reduced survival and poorer neurological outcomes following OHCA with 79% (74/94) of all reported adjusted results across 23 studies showing effect estimates suggesting lower survival with 42% (40/94) of these being statistically significant. OHCA survival was particularly reduced in patients with a prior history of diabetes (four out of six studies). However, a prearrest history of myocardial infarction appeared to be associated with increased survival in one of four studies.ConclusionsPrearrest comorbidity is generally associated with unfavourable OHCA outcomes, however differences between individual studies makes comparisons difficult. Due to the clinical and statistical heterogeneity across the studies, no meta-analysis was conducted. Future studies should follow a more standardised approach to investigating the impact of comorbidity on OHCA outcomes.PROSPERO registration numberCRD42018087578

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Systematic review of the relationship between comorbidity and out-of-hospital cardiac arrest outcomes

2019

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“…In einer retrospektiven Beobachtungsstudie konnte allerdings gezeigt werden, dass der Body-Mass-Index (BMI < 18,5 bis ≥30 kg/m 2 ) bei eCPR-Patienten weder mit einer erhöhten Mortalität noch mit einem schlechteren neurologischen Outcome assoziiert war [39]. Anderseits konnte in einer retrospektiven Studie gezeigt werden, dass die 1-Jahres-Überle-bensrate bei Patienten mit malignen Erkrankungen signifikant niedriger war als bei nichtmalignen Erkrankungen (1,7 % versus 11,4 %; [40]). Zudem ist zu berücksichtigen, dass ältere und gebrechliche Patienten mit OHCA eine niedrige Überlebenswahrscheinlichkeit zeigen [41].…”

Section: Introductionunclassified

Recommendations for extracorporeal cardiopulmonary resuscitation (eCPR)

Michels

Wengenmayer

Hagl

et al. 2018

Z Herz- Thorax- Gefäßchir

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Empfehlungen zur extrakorporalen kardiopulmonalen Reanimation (eCPR)

Michels

Wengenmayer

Hagl

et al. 2018

Med Klin Intensivmed Notfmed

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Extracorporeal cardiopulmonary resuscitation (eCPR) may be considered as a rescue attempt for highly selected patients with refractory cardiac arrest and potentially reversible etiology. Currently there are no randomized, controlled studies on eCPR, and valid predictors of benefit and outcome which might guide the indication for eCPR are lacking. Currently selection criteria and procedures differ across hospitals and standardized algorithms are lacking. Based on expert opinion, the present consensus statement provides a proposal for a standardized treatment algorithm for eCPR.

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Long-term survival of out-of-hospital cardiac arrest patients with malignancy

Cited by 14 publications

References 9 publications

Systematic review of the relationship between comorbidity and out-of-hospital cardiac arrest outcomes

Systematic review of the relationship between comorbidity and out-of-hospital cardiac arrest outcomes

Recommendations for extracorporeal cardiopulmonary resuscitation (eCPR)

Empfehlungen zur extrakorporalen kardiopulmonalen Reanimation (eCPR)

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