High survival rate of 43% in out-of-hospital cardiac arrest patients in an optimised chain of survival

被引:44
作者
Boyce, L. W. [1 ,8 ]
Vlieland, T. P. M. Vliet [1 ,2 ]
Bosch, J. [3 ]
Wolterbeek, R. [4 ]
Volker, G. [1 ]
van Exel, H. J. [1 ,5 ]
Heringhaus, C. [6 ]
Schalij, M. J. [5 ]
Goossens, P. H. [1 ,7 ]
机构
[1] Rijnlands Rehabil Ctr, NL-2333 AL Leiden, Netherlands
[2] Leiden Univ, Med Ctr, Dept Orthopaed, NL-2333 ZA Leiden, Netherlands
[3] Emergency Med Serv Hollands Midden, NL-2332 AA Leiden, Netherlands
[4] Leiden Univ, Med Ctr, Dept Med Stat, NL-2333 ZC Leiden, Netherlands
[5] Leiden Univ, Med Ctr, Dept Cardiol, NL-2333 ZA Leiden, Netherlands
[6] Leiden Univ, Med Ctr, Dept Accid & Emergency, NL-2333 ZA Leiden, Netherlands
[7] Leiden Univ, Med Ctr, Dept Rehabil, NL-2333 ZA Leiden, Netherlands
[8] Rijnlands Rehabil Ctr, NL-2300 AD Leiden, Netherlands
关键词
Out of hospital cardiac arrest; Survival; Cardiopulmonary resuscitation; RESUSCITATION; DEFIBRILLATORS;
D O I
10.1007/s12471-014-0617-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims Survival to hospital discharge after out-of-hospital cardiac arrest (OHCA) varies widely. This study describes short-term survival after OHCA in a region with an extensive care path and a follow-up of 1 year. Methods Consecutive patients >= 16 years admitted to the emergency department between April 2011 and December 2012 were included. In July 2014 a follow-up took place. Socio-demographic data, characteristics of the OHCA and interventions were described and associations with survival were determined. Results Two hundred forty-two patients were included (73 % male, median age 65 years). In 76 % the cardiac arrest was of cardiac origin and 52 % had a shockable rhythm. In 74 % the cardiac arrest was witnessed, 76 % received bystander cardiopulmonary resuscitation and in 39 % an automatic external defibrillator (AED) was used. Of the 168 hospitalised patients, 144 underwent therapeutic procedures. A total of 105 patients survived until hospital discharge. Younger age, cardiac arrest in public area, witnessed cardiac arrest, cardiac origin with a shockable rhythm, the use of an AED, shorter time until return of spontaneous circulation, Glasgow Coma Scale (GCS) >= 13 during transport and longer length of hospital stay were associated with survival. Of the 105 survivors 72 survived for at least 1 year after cardiac arrest and 6 patients died. Conclusion A survival rate of 43 % after OHCA is achievable. Witnessed cardiac arrest, cardiac cause of arrest, initial cardiac rhythm and GCS >= 13 were associated with higher survival.
引用
收藏
页码:20 / 25
页数:6
相关论文
共 11 条
[1]   Clinical review: Beyond immediate survival from resuscitation long-term outcome considerations after cardiac arrest [J].
Arawwawala, Dilshan ;
Brett, Stephen J. .
CRITICAL CARE, 2007, 11 (06)
[2]   Impact of Onsite or Dispatched Automated External Defibrillator Use on Survival After Out-of-Hospital Cardiac Arrest [J].
Berdowski, Jocelyn ;
Blom, Marieke T. ;
Bardai, Abdennasser ;
Tan, Hanno L. ;
Tijssen, Jan G. P. ;
Koster, Rudolph W. .
CIRCULATION, 2011, 124 (20) :2225-2232
[3]   Global incidences of out-of-hospital cardiac arrest and survival rates: Systematic review of 67 prospective studies [J].
Berdowski, Jocelyn ;
Berg, Robert A. ;
Tijssen, Jan G. P. ;
Koster, Rudolph W. .
RESUSCITATION, 2010, 81 (11) :1479-1487
[4]   Implantable Cardioverter-Defibrillators Have Reduced the Incidence of Resuscitation for Out-of-Hospital Cardiac Arrest Caused by Lethal Arrhythmias [J].
Hulleman, Michiel ;
Berdowski, Jocelyn ;
de Groot, Joris R. ;
van Dessel, Pascal F. H. M. ;
Borleffs, C. Jan Willem ;
Blom, Marieke T. ;
Bardai, Abdenasser ;
de Cock, Carel C. ;
Tan, Hanno L. ;
Tijssen, Jan G. P. ;
Koster, Rudolph W. .
CIRCULATION, 2012, 126 (07) :815-+
[5]   Emergency department factors associated with survival after sudden cardiac arrest [J].
Johnson, Nicholas J. ;
Salhi, Rama A. ;
Abella, Benjamin S. ;
Neumar, Robert W. ;
Gaieski, David F. ;
Carr, Brendan G. .
RESUSCITATION, 2013, 84 (03) :292-297
[6]   Predictors of Survival From Out-of-Hospital Cardiac Arrest A Systematic Review and Meta-Analysis [J].
Sasson, Comilla ;
Rogers, Mary A. M. ;
Dahl, Jason ;
Kellermann, Arthur L. .
CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, 2010, 3 (01) :63-U111
[7]   Consumption of diagnostic procedures and other cardiology care in chest pain patients after presentation at the emergency department [J].
Six, A. J. ;
Backus, B. E. ;
Kingma, A. ;
Kaandorp, S. I. .
NETHERLANDS HEART JOURNAL, 2012, 20 (12) :499-504
[8]   Hospital characteristics are associated with patient outcomes following out-of-hospital cardiac arrest [J].
Stub, Dion ;
Smith, Karen ;
Bray, Janet E. ;
Bernard, Stephen ;
Duffy, Stephen J. ;
Kaye, David M. .
HEART, 2011, 97 (18) :1489-1494
[9]   Cardiac rehabilitation uptake and its determinants in the Netherlands [J].
van Engen-Verheul, Mariette ;
de Vries, Han ;
Kemps, Hareld ;
Kraaijenhagen, Roderik ;
de Keizer, Nicolette ;
Peek, Niels .
EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, 2013, 20 (02) :349-356
[10]   Out-of-hospital cardiac arrests in Amsterdam and its surrounding areas: results from the Amsterdam resuscitation study (ARREST) in Utstein style. [J].
Waalewijn, RA ;
de Vos, R ;
Koster, RW .
RESUSCITATION, 1998, 38 (03) :157-167