Independent Predictors of 6-Month Mortality in Patients Successfully Resuscitated for Out-of-Hospital Cardiac Arrest:
Andreja Sinkovič1,2, Andrej Markota1, Martin Marinšek1
1Department of Medical Intensive Care, University Clinical Centre Maribor, Maribor, Slovenia.
Insights
Six-month mortality in out-of-hospital cardiac arrest (OHCA) survivors is high. Post-cardiac arrest brain injury is the strongest predictor of death in these patients.
Area of Science:
- Cardiology
- Neurology
- Critical Care Medicine
Background:
- Out-of-hospital cardiac arrest (OHCA) survival rates are improving.
- Understanding mortality predictors in successfully resuscitated OHCA patients is crucial.
Purpose of the Study:
- To identify independent predictors of six-month mortality in admitted OHCA patients.
Main Methods:
- Retrospective review of 119 OHCA patients admitted between 2011 and 2013.
- Data collected included clinical information, treatments, and potential mortality predictors.
Main Results:
- Six-month mortality was 47.5%.
- Predictors of mortality included older age, mechanical ventilation, longer resuscitation time, vasopressor use, and elevated serum lactate.
- Factors associated with lower mortality included shockable rhythm, percutaneous coronary intervention, therapeutic hypothermia, acute coronary syndromes, and neurological recovery.
Conclusions:
- Post-cardiac arrest brain injury is the most significant independent predictor of six-month mortality in OHCA patients.
- Neurological outcome is a critical factor influencing survival post-cardiac arrest.
Background:
Mortality of admitted out-of-hospital cardiac arrest (OHCA) patients is decreasing. Our aim was to evaluate independent predictors of six-month mortality of successfully resuscitated OHCA patients.
Methods:
We reviewed retrospectively the records of 119 OHCA patients, admitted in 2011 to 2013 (73.1% men, mean age 64 ± 13,5 years) and registered their clinical data, treatments, and predictors of 6-month mortality.
Results:
Six-month mortality of admitted OHCA patients was 47.5% and was associated significantly with older age (67.7 ± 12.9 years versus 59.9 ± 13 years, p < 0.05), mechanical ventilation, longer time of resuscitation (24.6 ± 18.9 sec versus 8.9 ± 8.4 sec, p < 0.05), use of vasopressors (87.3% versus 62.5%, p < 0.05), and increased serum lactate (8.1 ± 3.9 mmol/l versus 4.5 ± 3.6 mmol/l, p < 0.05) but less likely with prior shockable rhythm (38% versus 73.2%, p < 0.05), percutaneous coronary intervention (27% versus 55.4%, p < 0.05), achieved target temperatures 32°-34°C of mild therapeutic hypothermia (47.6% versus 71.4%, p < 0.05), acute coronary syndromes (31.7% versus 51.8%, p < 0.05), and neurological recovery (4.8% versus 69.6%, p < 0.05) when compared to survivors. Neurological outcome was most significant early independent predictor of 6-month mortality (OR 50.47; 95% CI 6.74 to 377.68; p < 0.001).
Conclusions:
Postcardiac arrest brain injury most significantly and independently predicted 6-month mortality in hospitalized OHCA patients.
Related Concept Videos
01:13Patient-centered Care
00:59Hospitals-II
Nurses that work in...
01:28Hospitals-I
01:11Observational Studies
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...
01:21Introduction to Test of Independence
The test statistic for a test of independence is similar to that of a goodness-of-fit test:
01:16Hypothesis Test for Test of Independence
H0: The two variables (factors)...