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Risk Stratification...
Risk Stratification Among Survivors of Cardiac Arrest Considered for Coronary Angiography
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- Harhash, Ahmed A. (författare)
- Univ Arizona, Sarver Heart Ctr, Tucson, AZ USA.;Univ Vermont, Burlington, VT USA.
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- May, Teresa L. (författare)
- Maine Med Ctr, Portland, ME 04102 USA.
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- Hsu, Chiu-Hsieh (författare)
- Univ Arizona, Coll Publ Hlth, Tucson, AZ USA.
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- Agarwal, Sachin (författare)
- Columbia Univ, New York, NY USA.
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- Seder, David B. (författare)
- Maine Med Ctr, Portland, ME 04102 USA.
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- Mooney, Michael R. (författare)
- Minneapolis Heart Inst, Minneapolis, MN USA.
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- Patel, Nainesh (författare)
- Lehigh Valley Med Ctr, Lehigh, PA USA.
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- McPherson, John (författare)
- Vanderbilt Univ, Med Ctr, Nashville, TN USA.
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- McMullan, Paul (författare)
- St Thomas Heart, Nashville, TN USA.
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- Riker, Richard (författare)
- Maine Med Ctr, Portland, ME 04102 USA.
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- Soreide, Eldar (författare)
- Stavanger Univ Hosp, Stavanger, Norway.
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- Hirsch, Karen G. (författare)
- Stanford Univ, Stanford, CA 94305 USA.
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- Stammet, Pascal (författare)
- Natl Fire & Rescue Corps, Luxembourg, Luxembourg.
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- Dupont, Alison (författare)
- Northside Hosp, Lawrenceville, GA USA.
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- Rubertsson, Sten (författare)
- Uppsala universitet,Anestesiologi och intensivvård
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- Friberg, Hans (författare)
- Lund Univ, Helsingborg, Sweden.
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- Nielsen, Niklas (författare)
- Lund Univ, Helsingborg, Sweden.
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- Rab, Tanveer (författare)
- Emory Univ, Sch Med, Atlanta, GA USA.
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- Kern, Karl B. (författare)
- Univ Arizona, Sarver Heart Ctr, Tucson, AZ USA.
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Univ Arizona, Sarver Heart Ctr, Tucson, AZ USA;Univ Vermont, Burlington, VT USA. Maine Med Ctr, Portland, ME 04102 USA. (creator_code:org_t)
- Elsevier, 2021
- 2021
- Engelska.
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Ingår i: Journal of the American College of Cardiology. - : Elsevier. - 0735-1097 .- 1558-3597. ; 77:4, s. 360-371
- Relaterad länk:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BackgroundThe American College of Cardiology Interventional Council published consensus-based recommendations to help identify resuscitated cardiac arrest patients with unfavorable clinical features in whom invasive procedures are unlikely to improve survival.ObjectivesThis study sought to identify how many unfavorable features are required before prognosis is significantly worsened and which features are most impactful in predicting prognosis.MethodsUsing the INTCAR (International Cardiac Arrest Registry), the impact of each proposed “unfavorable feature” on survival to hospital discharge was individually analyzed. Logistic regression was performed to assess the association of such unfavorable features with poor outcomes.ResultsSeven unfavorable features (of 10 total) were captured in 2,508 patients successfully resuscitated after cardiac arrest (ongoing cardiopulmonary resuscitation and noncardiac etiology were exclusion criteria in our registry). Chronic kidney disease was used in lieu of end-stage renal disease. In total, 39% survived to hospital discharge. The odds ratio (OR) of survival to hospital discharge for each unfavorable feature was as follows: age >85 years OR: 0.30 (95% CI: 0.15 to 0.61), time-to-ROSC >30 min OR: 0.30 (95% CI: 0.23 to 0.39), nonshockable rhythm OR: 0.39 (95% CI: 0.29 to 0.54), no bystander cardiopulmonary resuscitation OR: 0.49 (95% CI: 0.38 to 0.64), lactate >7 mmol/l OR: 0.50 (95% CI: 0.40 to 0.63), unwitnessed arrest OR: 0.58 (95% CI: 0.44 to 0.78), pH <7.2 OR: 0.78 (95% CI: 0.63 to 0.98), and chronic kidney disease OR: 0.96 (95% CI: 0.70 to 1.33). The presence of any 3 or more unfavorable features predicted <40% survival. Presence of the 3 strongest risk factors (age >85 years, time-to-ROSC >30 min, and non-ventricular tachycardia/ventricular fibrillation) together or ≥6 unfavorable features predicted a ≤10% chance of survival to discharge.ConclusionsPatients successfully resuscitated from cardiac arrest with 6 or more unfavorable features have a poor long-term prognosis. Delaying or even forgoing invasive procedures in such patients is reasonable.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- cardiac arrest
- coronary
- angiography
- risk stratification
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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Till lärosätets databas
- Av författaren/redakt...
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Harhash, Ahmed A ...
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May, Teresa L.
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Hsu, Chiu-Hsieh
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Agarwal, Sachin
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Seder, David B.
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Mooney, Michael ...
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visa fler...
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Patel, Nainesh
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McPherson, John
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McMullan, Paul
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Riker, Richard
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Soreide, Eldar
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Hirsch, Karen G.
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Stammet, Pascal
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Dupont, Alison
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Rubertsson, Sten
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Friberg, Hans
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Nielsen, Niklas
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Rab, Tanveer
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Kern, Karl B.
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visa färre...
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- MEDICIN OCH HÄLSOVETENSKAP
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Uppsala universitet