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Outcomes and interventions in patients transported to hospital with ongoing CPR after out-of-hospital cardiac arrest - an observational study
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Schmidbauer, S., Yates, E. J., Andréll, C., Bergström, D., Olson, H., Perkins, Gavin D. and Friberg, H. (2021) Outcomes and interventions in patients transported to hospital with ongoing CPR after out-of-hospital cardiac arrest - an observational study. Resuscitation Plus, 8 . 100170. doi:10.1016/j.resplu.2021.100170 ISSN 2666-5204.
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WRAP-outcomes-interventions-patients-transported-hospital-ongoing-CPR-out-of-hospital-cardiac-arrest-Perkins-2021.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (317Kb) | Preview |
Official URL: https://doi.org/10.1016/j.resplu.2021.100170
Abstract
Introduction:
The main objective was to present characteristics and outcome of patients without sustained field return of spontaneous circulation (ROSC) transported to hospital with ongoing cardiopulmonary resuscitation (CPR). Our secondary objectives were to investigate hospital-based interventions and the performance of the universal Termination of Resuscitation-rule (uTOR).
Methods:
In this retrospective observational cohort study, out-of-hospital cardiac arrest (OHCA) patients arriving to the emergency department of a university hospital in Sweden during a six-year period (2010–2015) were identified using a prospectively recorded hospital-based registry. Additional data were retrieved from medical records and from the Swedish cardiopulmonary resuscitation registry.
Results:
Among 409 patients transported with ongoing CPR, 7 survived to hospital discharge (1.7%). Hospital-based interventions against a suspected cause of arrest were attempted during ongoing resuscitation in 34 patients (8.3%), of whom 3 survived to hospital discharge. The remaining 4 survivors had spontaneous in-hospital ROSC. Survivors presented with either a shockable rhythm (n = 4) or pulseless electrical activity (n = 3). The uTOR identified non-survivors with a positive predictive value (PPV) of 98.4% and a specificity of 71.4% for termination.
Conclusion:
Survival after OHCA where sustained prehospital ROSC is not achieved is rare and available in-hospital interventions are rarely utilised. No patient with asystole as the first recorded rhythm survived. The uTOR identified non-survivors with a PPV of 98.4% but showed poor specificity.
| Item Type: | Journal Article | |||||||||||||||
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| Subjects: | R Medicine > RC Internal medicine | |||||||||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| SWORD Depositor: | Library Publications Router | |||||||||||||||
| Library of Congress Subject Headings (LCSH): | Cardiac resuscitation, Emergency medical services -- Utilization, CPR (First aid), Cardiovascular emergencies, Cardiac arrest -- Treatment -- Statistics, Cardiac arrest -- Treatment | |||||||||||||||
| Journal or Publication Title: | Resuscitation Plus | |||||||||||||||
| Publisher: | Elsevier | |||||||||||||||
| ISSN: | 2666-5204 | |||||||||||||||
| Official Date: | December 2021 | |||||||||||||||
| Dates: |
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| Volume: | 8 | |||||||||||||||
| Article Number: | 100170 | |||||||||||||||
| DOI: | 10.1016/j.resplu.2021.100170 | |||||||||||||||
| Status: | Peer Reviewed | |||||||||||||||
| Publication Status: | Published | |||||||||||||||
| Access rights to Published version: | Open Access (Creative Commons) | |||||||||||||||
| Date of first compliant deposit: | 25 October 2022 | |||||||||||||||
| Date of first compliant Open Access: | 25 October 2022 | |||||||||||||||
| RIOXX Funder/Project Grant: |
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