Document Detail

Long-term prognosis following resuscitation from out of hospital cardiac arrest: role of percutaneous coronary intervention and therapeutic hypothermia.
MedLine Citation:
PMID:  22742398     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The aim of the study was to assess the influence of percutaneous coronary intervention (PCI) and therapeutic hypothermia (TH) on long-term prognosis.
BACKGROUND: Although hospital care consisting of TH and/or PCI in particular patients resuscitated following out-of-hospital cardiac arrest (OHCA) can improve survival to hospital discharge, there is little evidence regarding how these therapies may impact long-term prognosis.
METHODS: We performed a cohort investigation of all persons >18 years of age who suffered nontraumatic OHCA and were resuscitated and discharged alive from the hospital between January 1, 2001, and December 31, 2009, in a metropolitan emergency medical service (EMS) system. We reviewed EMS and hospital records, state death certificates, and the national death index to determine clinical characteristics and vital status. Survival analyses were conducted using Kaplan-Meier estimates and multivariable Cox regression. Analyses of TH were restricted to those patients who were comatose at hospital admission.
RESULTS: Of the 5,958 persons who received EMS-attempted resuscitation, 1,001 (16.8%) were discharged alive from the hospital. PCI was performed in 384 of 1,001 (38.4%), whereas TH was performed in 241 of 941 (25.6%) persons comatose at hospital admission. Five-year survival was 78.7% among those treated with PCI compared with 54.4% among those not receiving PCI and 77.5% among those treated with TH compared with 60.4% among those not receiving TH (both p < 0.001). After adjustment for confounders, PCI was associated with a lower risk of death (hazard ratio [HR]: 0.46 [95% confidence interval [CI]: 0.34 to 0.61]; p < 0.001). Likewise, TH was associated with a lower risk of death (HR: 0.70 [95% CI: 0.50 to 0.97]; p = 0.04).
CONCLUSIONS: The findings suggested that effects of acute hospital interventions for post-resuscitation treatment extend beyond hospital survival and can positively influence prognosis following the arrest hospitalization.
Florence Dumas; Lindsay White; Benjamin A Stubbs; Alain Cariou; Thomas D Rea
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  60     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-06-29     Completed Date:  2012-08-31     Revised Date:  2013-01-14    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  21-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Emergency Medical Services Division of Public Health for Seattle and King County, Seattle, WA 98104, USA.
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MeSH Terms
Angioplasty, Balloon, Coronary*
Cardiopulmonary Resuscitation*
Cohort Studies
Emergency Service, Hospital
Hypothermia, Induced*
Kaplan-Meier Estimate
Middle Aged
Multivariate Analysis
Odds Ratio
Out-of-Hospital Cardiac Arrest / mortality*,  therapy*
Proportional Hazards Models
Risk Assessment
Risk Factors
Time Factors
United States / epidemiology
Comment In:
Rev Clin Esp. 2012 Dec;212(11):545

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

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