Outcome following admission to UK intensive care units after cardiac arrest: a secondary analysis of the ICNARC Case Mix Programme Database*

Abstract

SummaryUsing a retrospective analysis of the Intensive Care National Audit and Research Centre Case Mix Programme Database (ICNARC CMPD), we have summarised the characteristics and outcomes for mechanically ventilated patients admitted to UK intensive care units (ICUs) after cardiac arrest. Descriptive statistics on case mix, physiology, treatment, service delivery, outcome and activity were described separately for community cardiac arrest, in-hospital cardiac arrest (peri-operative) and in-hospital cardiac arrest (not peri-operative). The impact on outcome of several patient characteristics and physiological values were analysed using multivariable logistic regression. Mechanically ventilated survivors of cardiac arrest accounted for 24 132 (5.8%) of all admissions to the 174 ICUs in the ICNARC CMP. Of these, 10 347 (42.9%) survived to leave the ICU and 6778 (28.6%) survived to acute hospital discharge. The ICNARC model gives much better discrimination than APACHE II for predicting hospital mortality after admission to ICU following cardiac arrest: the predicted hospital mortality based on the APACHE II and ICNARC model was 41.9% and 79.7%, respectively.

Prognostic value of cell-free DNA in plasma of out-of-hospital cardiac arrest survivors at ICU admission and 24h post-admission

“…It has been established that many patients in UK are declared "do not attempt resuscitation" and care is withdrawn early in the post-arrest period, when proper prognostication is not possible [24,25]. Positive prognostic signal from a marker such as circulating DNA could reduce perception of likely adverse outcome, giving the patient a greater chance of recovery.…”

The precision of PiCCO®measurements in hypothermic post‐cardiac arrest patients

“…The management of patients following cardiac arrest who go on to receive therapeutic hypothermia is challenging [1][2][3]. Early arterial hypotension is common and is associated with increased in-hospital mortality [1,3,4].…”

Out-of-Hospital Cardiac Arrest: Better Prognosis When You Know the Cardiac Rhythm and You Can Shock it

“…Acute myocardial infarction (AMI) is known to be the most common cause of sudden cardiac arrest, and successful primary percutaneous coronary intervention (PCI) may improve survival in these patients [14][15][16][17][18][19][20]. Even if the role of PCI in OHCA might be controversial, diagnosing and treating an ongoing AMI as facilities were 6% in North America, 9% in Europe, and 11% in Australia [2].…”