Document Detail


Left ventricular systolic function and outcome after in-hospital cardiac arrest.
MedLine Citation:
PMID:  18378611     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Maria M Gonzalez; Robert A Berg; Vinay M Nadkarni; Caio B Vianna; Karl B Kern; Sergio Timerman; Jose A Ramires
Publication Detail:
Type:  Journal Article     Date:  2008-03-31
Journal Detail:
Title:  Circulation     Volume:  117     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-04-08     Completed Date:  2008-04-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1864-72     Citation Subset:  AIM; IM    
Affiliation:
Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paulo, Brazil.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / 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:
0/Adrenergic beta-Antagonists

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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