| Left ventricular systolic function and outcome after in-hospital cardiac arrest. | |
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MedLine Citation:
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PMID: 18378611 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The effect of prearrest left ventricular ejection fraction (LVEF) on outcome after cardiac arrest is unknown. METHODS AND RESULTS: During a 26-month period, Utstein-style data were prospectively collected on 800 consecutive inpatient adult index cardiac arrests in an observational, single-center study at a tertiary cardiac care hospital. Prearrest echocardiograms were performed on 613 patients (77%) at 11+/-14 days before the cardiac arrest. Outcomes among patients with normal or nearly normal prearrest LVEF (> or = 45%) were compared with those of patients with moderate or severe dysfunction (LVEF < 45%) by chi(2) and logistic regression analyses. Survival to discharge was 19% in patients with normal or nearly normal LVEF compared with 8% in those with moderate or severe dysfunction (adjusted odds ratio, 4.8; 95% confidence interval, 2.3 to 9.9; P<0.001) but did not differ with regard to sustained return of spontaneous circulation (59% versus 56%; P=0.468) or 24-hour survival (39% versus 36%; P=0.550). Postarrest echocardiograms were performed on 84 patients within 72 hours after the index cardiac arrest; the LVEF decreased 25% in those with normal or nearly normal prearrest LVEF (60+/-9% to 45+/-14%; P<0.001) and decreased 26% in those with moderate or severe dysfunction (31+/-7% to 23+/-6%, P<0.001). For all patients, prearrest beta-blocker treatment was associated with higher survival to discharge (33% versus 8%; adjusted odds ratio, 3.9; 95% confidence interval, 1.8 to 8.2; P<0.001). CONCLUSIONS: Moderate and severe prearrest left ventricular systolic dysfunction was associated with substantially lower rates of survival to hospital discharge compared with normal or nearly normal function. |
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Authors:
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Maria M Gonzalez; Robert A Berg; Vinay M Nadkarni; Caio B Vianna; Karl B Kern; Sergio Timerman; Jose A Ramires |
Publication Detail:
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Type: Journal Article Date: 2008-03-31 |
Journal Detail:
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Title: Circulation Volume: 117 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2008 Apr |
Date Detail:
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Created Date: 2008-04-08 Completed Date: 2008-04-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 1864-72 Citation Subset: AIM; IM |
Affiliation:
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Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use Aged Aged, 80 and over Brain Damage, Chronic / epidemiology, etiology Cardiopulmonary Resuscitation* Communicable Diseases / epidemiology Comorbidity Female Heart Arrest / complications*, therapy Hospital Mortality Hospitals, Special Humans Inpatients / statistics & numerical data* Male Middle Aged Multiple Organ Failure / etiology, mortality Pneumonia / epidemiology Prospective Studies Stroke Volume* Survival Analysis Systole Treatment Outcome Ventricular Dysfunction, Left / etiology*, ultrasonography |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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