Survival and neurologic recovery after out-of-hospital cardiac arrest

Abstract

Introduction/Objective: Survival and neurologic recovery after out-of-hospital cardiac arrest remain poor despite significant advances in the therapeutic approach. The study aimed to evaluate predictors of intrahospital survival and neurologic outcome among patients after outof-hospital cardiac arrest as well as to evaluate the influence of mild therapeutic hypothermia introduction on intrahospital survival and neurologic outcome among comatose patients after out-of-hospital cardiac arrest. Methods The research was conducted as a retrospective observational study among patients hospitalized at the Cardiac Intensive Care Unit of the Institute for Cardiovascular Diseases of Vojvodina from January 2007 until November 2019 as a result of an out-of-hospital cardiac arrest. Results. The research included 506 survivors of OHCA. Multivariate regression analysis showed that initial shockable rhythm, cardiopulmonary resuscitation efforts lasting no longer than 20 minutes and a Glasgow Coma Score above 8 at admission, were predictors of intrahospital survival and good neurological outcome. Introduction of mild therapeutic hypothermia improved intrahospital survival (54.1% vs. 24.4%; p < 0.0005) and neurological outcome (42.9% vs. 18.3%; p < 0.0005) in comatose patients with initial shockable rhythm. Conclusion. In our study group of out-of-hospital cardiac arrest patients, initial shockable rhythm, cardiopulmonary resuscitation efforts lasting no longer than 20min and a Glasgow Coma Score above 8 at admission were predictors of intrahospital survival and favourable neurological outcome. The introduction of mild therapeutic hypothermia significantly improved survival and neurological outcomes in comatose patients with initial shockable rhythms.

Keywords

• out-of-hospital cardiac arrest
• cardiopulmonary resuscitation
• mild therapeutic hypothermia
• predictors, good neurologic outcome