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Am J Emerg Med. 2017 Sep;35(9):1247-1251. doi: 10.1016/j.ajem.2017.03.050. Epub 2017 Mar 21.

Body mass index and outcome of out-of-hospital cardiac arrest patients not treated by targeted temperature management.

Author information

1
National and Kapodistrian University of Athens, Medical School, Postgraduate Study Program (MSc) "Cardiopulmonary Resuscitation", Athens, Greece.
2
National and Kapodistrian University of Athens, Medical School, "Evaggelismos" University Hospital, 1st Department of Intensive Care, Athens, Greece; Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece.
3
Psychiatric Hospital of Attica, Athens, Greece.
4
"Agios Panteleimon" General Hospital of Nikaia, Department of Neurosurgery, Piraeus, Greece.
5
Midwestern University of Chicago, College of Pharmacy, Department of Pharmaceutical Sciences, IL 60515, USA.
6
Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece; National and Kapodistrian University of Athens, Medical School, Aretaieio Hospital, Department of Neonatology, Athens, Greece.
7
National and Kapodistrian University of Athens, Medical School, Postgraduate Study Program (MSc) "Cardiopulmonary Resuscitation", Athens, Greece; Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece. Electronic address: thanoschalkias@yahoo.gr.
8
Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece; European University Cyprus, School of Medicine, Nicosia, Cyprus.

Abstract

BACKGROUND:

Obesity has been demonstrated to increase the risk of out-of-hospital cardiac arrest (OHCA) and may influence the quality and effectiveness of cardiopulmonary resuscitation. Our aim was to investigate the association between body mass index (BMI) and the outcome of OHCA victims not treated by targeted temperature management.

METHODS:

This was a prospective observational study of OHCA patients. The patients were categorized according to BMI into two groups: the normal BMI group (nBMI) and the elevated BMI group (eBMI). The primary endpoint was return of spontaneous circulation (ROSC), while secondary outcomes were survival to intensive care unit (ICU) admission and survival to ICU discharge.

RESULTS:

Of the initial 99 patients who were transported to the Emergency Department, 84 (85%) were included in the study. Mean BMI was 29.8kg/m2. Thirteen (15.5%) patients achieved ROSC and were admitted to the ICU, with the mean duration of ICU length of stay being 6.7±4.9days. Survival to ICU admission and ICU discharge were higher in the eBMI group (17.6% vs. 6.25%, p=0.010 and 10.3% vs. 6.25%, p=0.021, respectively). Survival to ICU discharge was higher in ventricular fibrillation patients compared to patients with non-shockable rhythms, irrespectively of their BMI (p=0.002). All patients that survived to ICU discharge did so with a cerebral performance category score of 2.

CONCLUSIONS:

Survival to ICU admission and ICU discharge were higher in the eBMI group.

KEYWORDS:

Body mass index; Cardiopulmonary resuscitation; Out-of-hospital cardiac arrest; Survival

PMID:
28363619
DOI:
10.1016/j.ajem.2017.03.050
[Indexed for MEDLINE]

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