Outcomes of out-of-hospital cardiac arrests after a decade of system-wide initiatives optimising community chain of survival in Taipei city

Lin, Hao-Yang; Chien, Yu-Chun; Lee, Bin-Chou; Wu, Yung-Lung; Liu, Yueh-Ping; Wang, Tzong-Luen; Ko, Patrick Chow-In; Chong, Kah-Meng; Wang, Hui-Chih; Huang, Edward Pei-Chuan; Sun, Jen‐Tang; Hsieh, Ming‐Ju; Hou, Sheng-Wen; Yang, Wen-Shuo; Wang, Yaocheng; Huang, Chengming; Chiang, Wen-Chu; Huei‐Ming, Matthew

doi:10.1016/j.resuscitation.2021.12.027

Cited by 12 publications

(10 citation statements)

References 35 publications

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“…Therapeutic hypothermia has emerged as a promising treatment in recent years for improving outcomes in OHCA patients 34 – 36 . There are many confounding variables that can affect both the cause and effect of OHCA 37 , 38 . For instance, differences in patient outcomes can be attributed to the management received at the emergency department following OHCA.…”

Section: Discussionmentioning

confidence: 99%

Effect of end-stage kidney disease on the return of spontaneous circulation in Taiwanese adults with out-of-hospital cardiac arrest

Hsieh

Chattopadhyay

et al. 2023

Sci Rep

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Rescuing patients with out-of-hospital cardiac arrest (OHCA), especially those with end-stage kidney disease (ESKD), is challenging. This study hypothesizes that OHCA patients with ESKD undergoing maintenance hemodialysis have (1) higher rates of return of spontaneous circulation (ROSC) during cardio-pulmonary resuscitation (CPR) and (2) lower rates of hyperkalemia and less severe acidosis than those without ESKD. OHCA patients who received CPR between 2011 and 2020 were dichotomized into ESKD and non-ESKD groups. The association of ESKD with “any” and “sustained” ROSC were examined using logistic regression analysis. Furthermore, the effect of ESKD on hospital outcomes for OHCA patients who survived to admission was evaluated using Kaplan–Meier analysis. ESKD patients without “any” ROSC displayed lower potassium and higher pH levels than non-ESKD patients. ESKD was positively associated with “any” ROSC (adjusted-OR: 4.82, 95% CI 2.70–5.16, P < 0.01) and “sustained” ROSC (adjusted-OR: 9.45, 95% CI 3.83–24.13, P < 0.01). Kaplan–Meier analysis demonstrated ESKD patients had a non-inferior hospital survival than non-ESKD patients. OHCA patients with ESKD had lower serum potassium level and less severe acidosis compared to the general population in Taiwan; therefore, should not be treated under the stereotypical assumption that hyperkalemia and acidosis always occur.

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Section: Discussionmentioning

confidence: 99%

Effect of end-stage kidney disease on the return of spontaneous circulation in Taiwanese adults with out-of-hospital cardiac arrest

Hsieh

Chattopadhyay

et al. 2023

Sci Rep

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“…For patients receiving conventional CPR (CCPR), statistics reveal a return of spontaneous circulation (ROSC) at 29.7%, survival to hospital admission at 22.0%, and survival to hospital discharge at 8.8% 2 . In Taiwan, post-resuscitation, only 24.9% exhibited ROSC, 7.8% survived to discharge, with only 3.7% achieve a favorable neurological outcome, with a mere 1% of CPR recipients experiencing a Cerebral Performance Category (CPC) score of 1 or 2 after enduring CPR for more than 35 minutes 3 .…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal cardiopulmonary resuscitation for patients with out-of-hospital cardiac arrest: A propensity score matching, observational study

Shih,

Lin,

Lin

et al. 2024

Preprint

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Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly performed as an adjunct to conventional cardiopulmonary resuscitation (CCPR) for out-of-hospital cardiac arrest (OHCA). However, the specific benefits of ECPR concerning survival with favorable neurological outcomes remain uncertain. This study aimed to investigate the comparative advantages of ECPR over CCPR in the management of OHCA. We conducted a retrospective cohort study as a single center involved OHCA patients between January 2016 and May 2021. Patients were categorized into ECPR or CCPR groups. The primary endpoint assessed was survival with favorable neurological outcomes, and the secondary outcome was survival rate. Multivariate logistic regression analyses, with and without 1:4 propensity score matching (PSM), were employed to assess ECPR’s effect. In total, 1792 patients were included: 111 underwent ECPR, and 1681 received CCPR. Compared to the CCPR group, the ECPR group exhibited notably higher rates of sustained return of spontaneous circulation (ROSC) (93.7% vs. 27.7%; p < 0.001), survival to discharge (38.7% vs. 13.9%; p < 0.001), and survival with favorable neurological outcome (22.5% vs. 6.0%; p < 0.001). Multivariate logistic regression analysis demonstrated that ECPR correlated with increased odds of survival with favorable neurological outcome (adjusted odds ratio: 1.79; 95% confidence interval (CI): 1.03–3.11; p < 0.037). Following PSM, the ECPR group showed significantly elevated odds of survival with favorable neurological outcomes (adjusted odds ratio: 2.22; 95% CI: 1.20–4.11; p = 0.010). This study demonstrated that in comparison to CCPR, ECPR may improve survival rates and odds of favorable neurological outcomes in OHCA patients.

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Section: Introductionmentioning

confidence: 99%

Extracorporeal cardiopulmonary resuscitation for patients with refractory out-of-hospital cardiac arrest: a propensity score matching, observational study

Shih,

Lin,

Lin

et al. 2024

Sci Rep

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Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly performed as an adjunct to conventional cardiopulmonary resuscitation (CCPR) for refractory out-of-hospital cardiac arrest (OHCA). However, the specific benefits of ECPR concerning survival with favorable neurological outcomes remain uncertain. This study aimed to investigate the potential advantages of ECPR in the management of refractory OHCA. We conducted a retrospective cohort study involved OHCA patients between January 2016 and May 2021. Patients were categorized into ECPR or CCPR groups. The primary endpoint assessed was survival with favorable neurological outcomes, and the secondary outcome was survival rate. Multivariate logistic regression analyses, with and without 1:2 propensity score matching, were employed to assess ECPR’s effect. In total, 1193 patients were included: 85underwent ECPR, and 1108 received CCPR. Compared to the CCPR group, the ECPR group exhibited notably higher survival rate (29.4% vs. 2.4%; p < 0.001). The ECPR group also exhibited a higher proportion of survival with favorable neurological outcome than CCPR group (17.6% vs. 0.7%; p < 0.001). Multivariate logistic regression analysis demonstrated that ECPR correlated with increased odds of survival with favorable neurological outcome (adjusted odds ratio: 13.57; 95% confidence interval (CI) 4.60–40.06). Following propensity score matching, the ECPR group showed significantly elevated odds of survival with favorable neurological outcomes (adjusted odds ratio: 13.31; 95% CI 1.61–109.9). This study demonstrated that in comparison to CCPR, ECPR may provide survival benefit and increase the odds of favorable neurological outcomes in selected OHCA patients.

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Outcomes of out-of-hospital cardiac arrests after a decade of system-wide initiatives optimising community chain of survival in Taipei city

Cited by 12 publications

References 35 publications

Effect of end-stage kidney disease on the return of spontaneous circulation in Taiwanese adults with out-of-hospital cardiac arrest

Effect of end-stage kidney disease on the return of spontaneous circulation in Taiwanese adults with out-of-hospital cardiac arrest

Extracorporeal cardiopulmonary resuscitation for patients with out-of-hospital cardiac arrest: A propensity score matching, observational study

Extracorporeal cardiopulmonary resuscitation for patients with refractory out-of-hospital cardiac arrest: a propensity score matching, observational study

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