Factors affecting the return of spontaneous circulation in cardiac arrest patients

Area of Science:

• Emergency Medicine
• Cardiology
• Resuscitation Science

Background:

• Out-of-hospital cardiac arrest (OHCA) remains a critical medical emergency with variable survival rates.
• International guidelines emphasize quality chest compressions for improving outcomes in cardiac arrest patients.
• Factors influencing the return of spontaneous circulation (ROSC) require further investigation to optimize resuscitation efforts.

Purpose of the Study:

• To identify key factors affecting ROSC in patients experiencing cardiac arrest.
• To analyze the impact of chest compression quality and duration on resuscitation outcomes.
• To determine predictors of mortality in OHCA patients undergoing automated cardiopulmonary resuscitation (CPR).

Main Methods:

• Retrospective observational study analyzing data from 452 nontraumatic OHCA patients treated between January 2018 and December 2019.
• Patients received automated CPR device for chest compressions.
• Logistic regression analysis was employed to identify factors influencing mortality and ROSC, with a significance threshold of P < 0.05.

Main Results:

• A CPR duration exceeding 42 minutes was associated with a 6.2-fold increase in the probability of ROSC (OR: 6.232, P < .05).
• Lower thrombocyte counts (<199 × 10^9/L) correlated with a 0.5-fold increase in mortality rate (OR: 0.482).
• The study population comprised 61.7% males, with 65.0% experiencing OHCA; 19.5% had a shockable rhythm requiring defibrillation.

Conclusions:

• CPR duration is a significant factor influencing ROSC, suggesting a minimum duration of 42 minutes may be beneficial.
• Thrombocyte count appears to be a potential predictor of mortality in cardiac arrest patients.
• While consensus on ideal resuscitation duration is lacking, findings support extended CPR efforts in select cases.