Coronary Artery DiseasePredictors of Survival and Favorable Functional Outcomes After an Out-of-Hospital Cardiac Arrest in Patients Systematically Brought to a Dedicated Heart Attack Center (from the Harefield Cardiac Arrest Study)
Section snippets
Methods
This was an observational analysis to determine the predictors of favorable functional status at discharge and long-term survival in 182 consecutive patients experiencing an OOHCA from 2011 to 2013 who were brought directly by the emergency medical services (EMS) to Harefield Hospital, Middlesex—1 of 8 designated heart attack centers in London. Of these, return of spontaneous circulation was achieved in 174 patients (96%) and included in the final analysis. The LAS is the largest free emergency
Results
The patient characteristics are summarized in Table 1. For the 174 patients who were successfully resuscitated, (1) the mortality rate was 33.3% at 30 days and 37.9% at 1 year and (2) 63.5% survived to hospital discharge with 54.6% having a favorable functional status (mRS0-3+).
Multivariate logistic regression analyses were used to identify independent predictors of mRS0-3+ (Figure 1). Consistent predictors of mRS0-3+ in both models included a lower CMI, absence of cardiogenic shock, bystander
Discussion
Despite advances in CPR, functional survival rate remains low after OOHCA.1, 12 Survival is a net result of different factors ranging from application of medical science; public awareness and education; availability of resources and personnel; and local implement of infrastructure. The concept of HACs provides a system of strategically utilizing available resources required to meet the acute and complex need of these patients.12, 13 Studies have shown that 80% of OOHCAs have a cardiac cause,3, 8
Disclosures
The authors have no conflicts of interest to disclose.
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