Out-of-hospital cardiac arrest: data from the National Registry of Invasive Cardiology Procedures (ORPKI) in a long-term survival analysis of patients with acute coronary syndromes in a Polish region

Sielski, Janusz; Kaziród-Wolski, Karol; Siudak, Zbigniew

doi:10.33963/kp.15244

Cited by 8 publications

(17 citation statements)

References 21 publications

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“…In two previous studies, based on the registry of patients treated with hypothermia (The Polish Registry of Therapeutic Hypothermia) and the registry of invasive cardiac procedures (National Registry of Invasive Procedures -ORPKI), the percentage of patients who survived to hospital discharge was 81% and 87%, respectively. However, one must note that these studies refer to highly selected groups of patients after OHCA [14,25]. In the cohort of consecutive OHCA patients admitted to the hospital with sustained ROSC in 2004, the survival rate was 31.9%, which is much lower than in the studies mentioned above and was similar to our results, where 30.0% of these patients survived to discharge [13].…”

Section: Discussionsupporting

confidence: 84%

Epidemiology, management, and survival rate of out-of-hospital cardiac arrest in Upper Silesia, Poland: an Utstein-style report

Bujak¹,

Nadolny²,

Ładny³

et al. 2021

pwki

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Introduction: Despite the growing number of studies on the epidemiology of out-of-hospital cardiac arrest (OHCA) in Poland, this issue has not been sufficiently studied. Notably, there has been a lack of uniform Utstein-style data reporting.Aim: To evaluate the epidemiology of OHCA, patient characteristics, the laypeople and emergency medical service (EMS) response to cardiac arrest, and outcomes of OHCA patients, based on a prospective registry encompassing a population of 2.7 million Poles.Material and methods: Consecutive, adult, EMS-treated OHCA cases in 2018 were analyzed. Prehospital data were collected using case report forms by EMS. Information on in-hospital procedures and outcomes was based on data from the public payer of health care services. Multivariable logistic regression analysis was performed to find independent predictors of survival to discharge.Results: A total of 1392 patients were included. Most OHCA occurred at home (74.7%). In 66.8% of OHCA cases, the cardiac arrest was witnessed by bystanders and in another 20.4% by EMS. Laypeople performed cardiopulmonary resuscitation (CPR) in 54.4% of non-EMS-witnessed events, and an automated external defibrillator (AED) was used in 4.6% of patients who received bystander CPR. Finally, 30.7% of all patients were transported to the hospital, and 9.2% survived to hospital discharge. Epinephrine administration, unwitnessed OHCA, longer response time, older age, and initial non-shockable rhythm were independently associated with lower survival to discharge.Conclusions: The prognosis of OHCA patients in Poland is poor. There is still room for improvement in increasing the prevalence of bystander CPR and AED use before EMS arrival.

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Section: Discussionsupporting

confidence: 84%

Epidemiology, management, and survival rate of out-of-hospital cardiac arrest in Upper Silesia, Poland: an Utstein-style report

Bujak¹,

Nadolny²,

Ładny³

et al. 2021

pwki

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“…After removing duplicates (n = 5296), the remaining 10 051 records were screened on titles and abstracts. Of the resulting 854 full-text articles, 38 studies were included in the final qualitative and quantitative analysis. A total of 21 studies with 11 800 patients were used for KM-based meta-analysis, whereas 33 studies with 16 933 patients were used for aggregate data meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Long-term Survival After Out-of-Hospital Cardiac Arrest

et al. 2022

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IMPORTANCE Data on long-term survival beyond 12 months after out-of-hospital cardiac arrest (OHCA) of a presumed cardiac cause are scarce.OBJECTIVE To investigate the long-term survival of adult patients after surviving the initial hospital stay for an OHCA.DATA SOURCES A systematic search of the EMBASE and MEDLINE databases was performed from database inception to March 25, 2021.STUDY SELECTION Clinical studies reporting long-term survival after OHCA were selected based on predefined inclusion and exclusion criteria according to a preregistered study protocol.DATA EXTRACTION AND SYNTHESIS Patient data were reconstructed from Kaplan-Meier curves using an iterative algorithm and then pooled to generate survival curves. As a separate analysis, an aggregate data meta-analysis was performed. MAIN OUTCOMES AND MEASURESThe primary outcome was long-term survival (>12 months) after OHCA for patients surviving to hospital discharge or 30 days after OHCA. RESULTSThe search identified 15 347 reports, of which 21 studies (11 800 patients) were included in the Kaplan-Meier-based meta-analysis and 33 studies (16 933 patients) in an aggregate data meta-analysis. In the Kaplan-Meier-based analysis, the median survival time for patients surviving to hospital discharge was 5.0 years (IQR, 2.3-7.9 years). The estimated survival rates were 82.8% (95% CI, 81.9%-83.7%) at 3 years, 77.0% (95% CI, 75.9%-78.0%) at 5 years, 63.9% (95% CI, 62.3%-65.4%) at 10 years, and 57.5% (95% CI, 54.8%-60.1%) at 15 years. Compared with patients with a nonshockable initial rhythm, patients with a shockable rhythm had a lower risk of long-term mortality (hazard ratio, 0.30; 95% CI, 0.23-0.39; P < .001). Different analyses, including an aggregate data meta-analysis, confirmed these results. CONCLUSIONS AND RELEVANCEIn this comprehensive systematic review and meta-analysis, long-term survival after 10 years in patients surviving the initial hospital stay after OHCA was between 62% and 64%. Additional research is needed to understand and improve the long-term survival in this vulnerable patient population.

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“…For several years, the authors conducted studies on large groups of patients and cardiac registries. These studies used perioperative death as an endpoint [27,28]. The COVID-19 pandemic, which occurred between 2020 and 2021, caused significant changes in the healthcare system and patient management (including ACS patients being eligible for invasive treatment).…”

Section: Discussionmentioning

confidence: 99%

The Effect of COVID-19 on the Perioperative Course of Acute Coronary Syndrome in Poland: The Estimation of Perioperative Prognosis and Neural Network Analysis in 243,515 Cases from 2020 to 2021

Kaziród-Wolski

Zając²,

Zabojszcz

et al. 2022

JCM

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COVID-19 causes thromboembolic complications that affect the patient’s prognosis. COVID‑19 vaccines significantly improve the prognosis for the course of the infection. The aim of this study was to evaluate the impacts of patient characteristics, including COVID-19 vaccinations, on perioperative mortality in acute coronary syndrome in Poland during the pandemic. We analyzed the data of 243,515 patients from the National Registry of Invasive Cardiology Procedures (Ogólnopolski Rejestr Procedur Kardiologii Inwazyjnej [ORPKI]). In this group, 7407 patients (21.74%) had COVID-19. The statistical analysis was based on a neural network that was verified by the random forest method. In 2020, the most significant impact on prognosis came from a diagnosis of unstable angina, a short period (<2 h) from pain occurrence to first medical contact, and a history of stroke. In 2021, the most significant factors were pre-hospital cardiac arrest, female sex, and a short period (<2 h) from first medical contact to coronary angiography. After adjusting for a six-week lag, a diagnosis of unstable angina and psoriasis were found to be relevant in the data from 2020, while in 2021, it was the time from the pain occurrence to the first medical contact (2–12 h) in non-ST segment elevation myocardial infarction and the time from first contact to balloon inflation (2–12 h) in ST-segment elevation myocardial infarction. The number of vaccinations was one of the least significant factors. COVID-19 vaccination does not directly affect perioperative prognosis in patients with acute coronary syndrome.

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Out-of-hospital cardiac arrest: data from the National Registry of Invasive Cardiology Procedures (ORPKI) in a long-term survival analysis of patients with acute coronary syndromes in a Polish region

Cited by 8 publications

References 21 publications

Epidemiology, management, and survival rate of out-of-hospital cardiac arrest in Upper Silesia, Poland: an Utstein-style report

Epidemiology, management, and survival rate of out-of-hospital cardiac arrest in Upper Silesia, Poland: an Utstein-style report

Long-term Survival After Out-of-Hospital Cardiac Arrest

The Effect of COVID-19 on the Perioperative Course of Acute Coronary Syndrome in Poland: The Estimation of Perioperative Prognosis and Neural Network Analysis in 243,515 Cases from 2020 to 2021

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