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Resuscitation. 2009 Jul;80(7):795-804. doi: 10.1016/j.resuscitation.2009.04.004. Epub 2009 May 2.

Long-term prognosis after out-of-hospital cardiac arrest with/without ST elevation myocardial infarction.

Author information

1
First Department of Internal Medicine, University Hospital, Charles University in Prague, Hradec Kralove, Czech Republic. pleskot@fnhk.cz

Abstract

AIM:

To describe the 3-year survival of patients after out-of-hospital cardiac arrest (OHCA) taking into account the presence of ST-segment elevation myocardial infarction (STEMI) and evaluating prognostic factors associated with pre-hospital and hospital care.

PATIENT GROUP:

Over a period of 29 months and with the aid of a questionnaire supplied to 24 rescue stations, we prospectively included 560 individuals (415 men; aged 16-97 years, median 68) for whom cardio-pulmonary resuscitation (CPR) for OHCA of confirmed cardiac etiology was attempted.

RESULTS:

Of 149 hospitalized individuals, 28.2% survived 1 year and 25.5% survived 3 years after OHCA. In the subgroup of patients with STEMI (26 individuals; 17.5%), 57.7% survived 1 year and 53.9% survived 3 years. In the subgroup of patients without STEMI (n=123), 22% survived 1 year and 19.5% survived 3 years. The strongest predictors for long-term survival by logistic regression analysis were: age under 70 years, ventricular fibrillation as initial rhythm, CPR without atropine, and STEMI. OHCA occurrence at a public place was an indicator of better survival in the subgroup with STEMI. In the subgroup of patients without STEMI, long-term angiotensin-converting enzyme inhibitor treatment, CPR without atropine, a Glasgow Coma Scale upon hospital admission over 3, no presence of cardiogenic shock, and no manifestations of postanoxic encephalopathy (Fisher's exact test, chi(2) test) were indicators of better survival.

CONCLUSION:

Among 560 individuals with "primary cardiac" etiology OHCA and initiation of professional CPR, 8% survived 1 year and 7% survived 3 years. A higher survival rate among patients with STEMI was documented.

[Indexed for MEDLINE]

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