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Outcome predictors of patients with out of hospital cardiac arrest and immediate coronary angiography
Author(s) -
Almalla Mohammad,
Kersten Alexander,
Altiok Ertunc,
Burgmaier Mathias,
Marx Nikolaus,
Schröder Jörg
Publication year - 2020
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28582
Subject(s) - medicine , return of spontaneous circulation , retrospective cohort study , coronary angiography , multivariate analysis , single center , angiography , cardiopulmonary resuscitation , cardiology , emergency medicine , resuscitation , myocardial infarction
Background Out of hospital cardiac arrest (OHCA) is common and associated with low survival rates. Guidelines propose a fast work‐up after OHCA including coronary angiography (CA) but little is known about the actual outcome of those patients who undergo immediate CA after OHCA with suspected cardiac origin. Aim The aim of this retrospective single‐center study was to evaluate the short‐term outcomes and predictors of in‐hospital mortality in patients who underwent immediate CA after OHCA with suspected cardiac origin. Methods We included all consecutive patients with OHCA who underwent immediate CA between January 2011 and December 2015. We defined immediate CA after OHCA as angiography within 2 hr after admission. Results Two hundred and nineteen consecutive patients with OHCA were included. Fifty six patients (26%) underwent CA without previous return of spontaneous circulation (ROSC) and with ongoing CPR using the LUCAS‐device. One hundred and forty nine patients (67%) died in hospital. Of the 56 patients with CA with ongoing CPR, 55 died and only 1 patient survived to hospital discharge. In a multivariate analysis, older age (OR = 2.03, 95%CI 1.35–3.03; p = .001), initial shockable rhythm (OR = 0.28, 95%CI 0.07–1.13; p = .076), CA with ongoing CPR (OR = 11.63, 95%CI 1.20–122.55; p = .035), and initial arterial pH (OR = 0.008, 95%CI 0.00–0.228; p < .005) remained as independent predictors for in‐hospital mortality. Conclusions In this study older age, metabolic derangement on admission, initial nonshockable rhythm and failure to achieve ROSC before admission predicted in‐hospital mortality. While CA with ongoing CPR with the LUCAS‐device was feasible, mortality in patients without previous ROSC was extremely high, questioning whether this approach is medically useful.