Mode of death after admission to an intensive care unit following cardiac arrest

Laver, Stephen R.; Farrow, Catherine; Turner, Duncan L.; Nolan, Jerry P.

doi:10.1007/s00134-004-2425-z

Cited by 860 publications

(533 citation statements)

References 12 publications

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“…Patients with anoxic encephalopathy were included because by far the most common cause of death for survivors of out-ofhospital cardiac arrest is failure to awaken owing to severe neurological injury. 37 The primary outcome of interest in this study was hospital mortality. Using information from the Alberta Health Services discharge abstract database, we were also able to determine whether patients had been discharged home (with or without support services), to another institution, or to a long-term nursing care facility.…”

Section: Methodsmentioning

confidence: 99%

Declining mortality in neurocritical care patients: a cohort study in Southern Alberta over eleven years

Kramer

Zygun

2013

Can J Anesth/J Can Anesth

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Section: Methodsmentioning

confidence: 99%

Declining mortality in neurocritical care patients: a cohort study in Southern Alberta over eleven years

Kramer

Zygun

2013

Can J Anesth/J Can Anesth

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“…Arrest location correlates highly with survival, 10% at hospital discharge after out‐of‐hospital cardiac arrest (OHCA) versus 25% in‐hospital,1 with neurologic injury the leading cause of morbidity and mortality 2. Targeted temperature management (TTM), previously termed therapeutic hypothermia,3 is now the standard of care for comatose patients following cardiac arrest.…”

Section: Introductionmentioning

confidence: 99%

C‐GRApH : A Validated Scoring System for Early Stratification of Neurologic Outcome After Out‐of‐Hospital Cardiac Arrest Treated With Targeted Temperature Management

Kiehl

Parker

Matar

et al. 2017

JAHA

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BackgroundOut‐of‐hospital cardiac arrest (OHCA) results in significant morbidity and mortality, primarily from neurologic injury. Predicting neurologic outcome early post‐OHCA remains difficult in patients receiving targeted temperature management.Methods and ResultsRetrospective analysis was performed on consecutive OHCA patients receiving targeted temperature management (32–34°C) for 24 hours at a tertiary‐care center from 2008 to 2012 (development cohort, n=122). The primary outcome was favorable neurologic outcome at hospital discharge, defined as cerebral performance category 1 to 2 (poor 3–5). Patient demographics, pre‐OHCA diagnoses, and initial laboratory studies post‐resuscitation were compared between favorable and poor neurologic outcomes with multivariable logistic regression used to develop a simple scoring system (C‐GRApH). The C‐GRApH score ranges 0 to 5 using equally weighted variables: (C): coronary artery disease, known pre‐OHCA; (G): glucose ≥200 mg/dL; (R): rhythm of arrest not ventricular tachycardia/fibrillation; (A): age >45; (pH): arterial pH ≤7.0. A validation cohort (n=344) included subsequent patients from the initial site (n=72) and an external quaternary‐care health system (n=272) from 2012 to 2014. The c‐statistic for predicting neurologic outcome was 0.82 (0.74–0.90, P<0.001) in the development cohort and 0.81 (0.76–0.87, P<0.001) in the validation cohort. When subdivided by C‐GRApH score, similar rates of favorable neurologic outcome were seen in both cohorts, 70% each for low (0–1, n=60), 22% versus 19% for medium (2–3, n=307), and 0% versus 2% for high (4–5, n=99) C‐GRApH scores in the development and validation cohorts, respectively.Conclusions C‐GRApH stratifies neurologic outcomes following OHCA in patients receiving targeted temperature management (32–34°C) using objective data available at hospital presentation, identifying patient subsets with disproportionally favorable (C‐GRApH ≤1) and poor (C‐GRApH ≥4) prognoses.

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“…Approximately a quarter of the patients who survive the initial cardiac arrest will ultimately die of neurologic injury. 21 Although many patients ultimately die of neurologic devastation after cardiac arrest, some experience significant myocardial dysfunction and systemic inflammation. Similar to sepsis syndrome, the period immediately after cardiac arrest is characterized by elevated serologic markers of global inflammation, endothelial dysfunction, and microcirculatory hypoperfusion.…”

Section: Post-cardiac Arrest Syndromementioning

confidence: 99%

From Door to Recovery: A Collaborative Approach to the Development of a Post–Cardiac Arrest Center

Williams

Calder²,

Cocchi³

et al. 2013

Critical Care Nurse

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Out-of-hospital cardiac arrest remains common and, despite advances in resuscitation practices, continues to carry a high mortality that may be influenced by several factors, including where a patient is cared for after the cardiac arrest. Implementing a post–cardiac arrest care guideline for survivors of out-of-hospital and in-hospital cardiac arrest involves a multidisciplinary approach with short-term and long-term strategies. Physician and nursing leaders must work in synergy to guide the implementation of an evidence-based plan of care. A collaborative approach was used at a hospital to develop processes, build consensus for protocols, and provide support to staff and teams. A joint approach has allowed the hospital to move from traditional silos of individual departmental care to a continuum of patient-focused management after cardiac arrest. This care coordination is initiated in the emergency department and follows the patient through to discharge.

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Mode of death after admission to an intensive care unit following cardiac arrest

Cited by 860 publications

References 12 publications

Declining mortality in neurocritical care patients: a cohort study in Southern Alberta over eleven years

Declining mortality in neurocritical care patients: a cohort study in Southern Alberta over eleven years

C‐GRApH : A Validated Scoring System for Early Stratification of Neurologic Outcome After Out‐of‐Hospital Cardiac Arrest Treated With Targeted Temperature Management

From Door to Recovery: A Collaborative Approach to the Development of a Post–Cardiac Arrest Center

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