| Factors associated with neurologically intact survival for patients with acute heart failure and in-hospital cardiac arrest. | |
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MedLine Citation:
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PMID: 19919982 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Hospitalized patients with heart failure are at risk for cardiac arrest. The ability to predict who may survive such an event with or without neurological deficit would enhance the information on which patients and providers establish resuscitative preferences. METHODS AND RESULTS: We identified 13 063 adult patients with acute heart failure who had cardiac arrest at 457 hospitals participating in the National Registry of Cardiopulmonary Resuscitation between January 1, 2000 and December 31, 2007. Neurological status was determined on admission and discharge by cerebral performance category with neurologically intact survival (NIS)=cerebral performance category 1 (no) or 2 (moderate dysfunction) and non-NIS=cerebral performance category 3 (severe dysfunction), 4 (coma), or 5 (brain death). Factors available prearrest (demographics, preexisting conditions, and interventions in-place) were assessed for association with NIS using multivariable logistic regression, initially without then with adjustment for arrest-related variables and hospital characteristics. NIS occurred in 2307 patients (17.7%) and was associated by adjusted odds ratio with 18 prearrest factors; 4 positively and 14 negatively. The association (odds ratio; 95% CI) was strongest for 4 specific variables: acute stroke (0.38; 0.25 to 0.58), history of malignancy (0.49; 0.39 to 0.63), vasopressor use (0.50; 0.43 to 0.59), and assisted or mechanical ventilation (0.53; 0.45 to 0.61). CONCLUSIONS: A number of prearrest factors seem to be associated with NIS, the majority inversely. Consideration of these before cardiac arrest could enhance the resuscitative decision-making process for patients with acute heart failure. |
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Authors:
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Phillip D Levy; Hong Ye; Scott Compton; Paul S Chan; Gregory Luke Larkin; Robert D Welch; |
Publication Detail:
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Type: Journal Article; Multicenter Study Date: 2009-09-28 |
Journal Detail:
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Title: Circulation. Heart failure Volume: 2 ISSN: 1941-3297 ISO Abbreviation: Circ Heart Fail Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-11-20 Completed Date: 2009-12-03 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101479941 Medline TA: Circ Heart Fail Country: United States |
Other Details:
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Languages: eng Pagination: 572-81 Citation Subset: IM |
Affiliation:
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Department of Emergency Medicine and the Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, Michigan, USA. plevy@med.wayne.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aged Aged, 80 and over Brain / physiopathology* Cardiopulmonary Resuscitation* Disability Evaluation Female Heart Arrest / etiology*, mortality, physiopathology, therapy Heart Failure / complications*, mortality, physiopathology Humans Inpatients* / statistics & numerical data Logistic Models Male Middle Aged Nervous System Diseases / etiology*, mortality, physiopathology Odds Ratio Patient Selection Registries Retrospective Studies Risk Assessment Risk Factors Survival Analysis Treatment Outcome United States / epidemiology |
| Investigator | |
Investigator/Affiliation:
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Tim Mader / ; Karl B Kern / ; Sam Warren / ; Graham Nichol / ; Thomas Noel / ; Joseph P Ornato / ; Mary Ann Peberdy / ; Romergryko Geocadin / ; Scott Braithwaite / ; Mary E Mancini / ; Robert A Berg / ; Emilie Allen / ; Kathy Duncan / ; Vinay M Nadkarni / ; Gregory Luke Larkin / ; John Gosbee / ; Greg Mears / ; Elizabeth A Hunt / ; Tanya Lane Truitt / ; William Kaye / ; Melinda Smyth / ; Jerry Potts / ; Brian Eigel / ; P Chan / ; E Allen / ; S Berg / ; S Braithwaite / ; B Eigel / ; R Geocadin / ; E Hunt / ; K Kern / ; G Larkin / ; T Mader / ; M Mancini / ; V Nadkarni / ; G Nichol / ; T Noel / ; J Ornato / ; M Peberdy / ; J Potts / ; T Truitt / ; S Warren / |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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