Post-resuscitation electrocardiograms, acute coronary findings and in-hospital prognosis of survivors of out-of-hospital cardiac arrest. [artículo]
Por: García Tejada, Julio [Cardiología]
| Jurado Román, Alfonso [Cardiología] | Rodríguez García, Jesús A [Medicina Intensiva] | Velázquez Martín, María Teresa [Cardiología] | Hernández Hernández, Felipe [Cardiología] | Albarrán González-Trevilla, Agustín [Cardiología] | Martín Asenjo, Roberto [Cardiología] | Granda Nistal, Carolina [Cardiología] | Coma Samartín, Raúl [Cardiología] | Tascón Pérez, Juan Carlos [Cardiología].
Colaborador(es): Servicio de Cardiología | Servicio de Medicina Intensiva.
Tipo de material: 
ArtículoEditor: Resuscitation, 2014Descripción: 85(9):1245-50.Recursos en línea: Solicitar documento Resumen: Background: Identification of acute coronary lesions amenable to urgent intervention in survivors of out-of-hospital cardiac arrest is crucial. We aimed to compare the clinical and electrocardiographic characteristics to urgent coronary findings, and to analyze in-hospital prognosis of these patients.
Methods: From January 2005 to December 2012 we retrospectively identified consecutive patients resuscitated from out-of-hospital cardiac arrest, and analyzed the clinical characteristics, post-resuscitation electrocardiogram and coronary angiogram of those who underwent emergent angiography. Mortality and neurologic status at discharge were also assessed.
Results: Patients with ST-elevation more frequently had obstructive coronary artery disease (89% vs. 51%, p<0.001) or acute coronary occlusions (83% vs. 8%, p<0.001) than patients without ST-elevation. Independent predictors of an acute coronary occlusion were chest pain before arrest (OR 0.16, 95% CI 0.04-0.7, p=0.01), a shockable initial rhythm (OR 0.16, 95% CI 0.03-0.9, p=0.03), and ST-elevation on the post-resuscitation electrocardiogram (OR 0.02, 95% CI 0.004-0.13, p<0.001). Survival with favorable neurologic recovery at discharge was 59%. Independent predictors of mortality or unfavorable neurological outcome at discharge were absence of basic life support (OR 0.2, 95% CI 0.06-0.9, p=0.04), prolonged resuscitation time (OR 0.9, 95% CI 0.8-0.9, p=0.01), and necessity of vasopressors (OR 14.8, 95% CI 3.3-65.4, p=0.001).
Conclusions: Most patients with ST-elevation on the post-resuscitation electrocardiogram had an acute coronary occlusion, as opposed to patients without ST-elevation. Absence of basic life support, prolonged resuscitation time and use of vasopressors were independent predictors of worse in-hospital outcome.
| Tipo de ítem | Ubicación actual | Signatura | Estado | Fecha de vencimiento |
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Artículo
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PC16538 (Navegar estantería) | Disponible |
Formato Vancouver:
Garcia Tejada J, Jurado Román A, Rodríguez J, Velázquez M, Hernández F, Albarrán A et al. Post-resuscitation electrocardiograms, acute coronary findings and in-hospital prognosis of survivors of out-of-hospital cardiac arrest. Resuscitation. 2014 Sep;85(9):1245-50.
PMID: 24929199
Contiene 25 referencias
Background: Identification of acute coronary lesions amenable to urgent intervention in survivors of out-of-hospital cardiac arrest is crucial. We aimed to compare the clinical and electrocardiographic characteristics to urgent coronary findings, and to analyze in-hospital prognosis of these patients.
Methods: From January 2005 to December 2012 we retrospectively identified consecutive patients resuscitated from out-of-hospital cardiac arrest, and analyzed the clinical characteristics, post-resuscitation electrocardiogram and coronary angiogram of those who underwent emergent angiography. Mortality and neurologic status at discharge were also assessed.
Results: Patients with ST-elevation more frequently had obstructive coronary artery disease (89% vs. 51%, p<0.001) or acute coronary occlusions (83% vs. 8%, p<0.001) than patients without ST-elevation. Independent predictors of an acute coronary occlusion were chest pain before arrest (OR 0.16, 95% CI 0.04-0.7, p=0.01), a shockable initial rhythm (OR 0.16, 95% CI 0.03-0.9, p=0.03), and ST-elevation on the post-resuscitation electrocardiogram (OR 0.02, 95% CI 0.004-0.13, p<0.001). Survival with favorable neurologic recovery at discharge was 59%. Independent predictors of mortality or unfavorable neurological outcome at discharge were absence of basic life support (OR 0.2, 95% CI 0.06-0.9, p=0.04), prolonged resuscitation time (OR 0.9, 95% CI 0.8-0.9, p=0.01), and necessity of vasopressors (OR 14.8, 95% CI 3.3-65.4, p=0.001).
Conclusions: Most patients with ST-elevation on the post-resuscitation electrocardiogram had an acute coronary occlusion, as opposed to patients without ST-elevation. Absence of basic life support, prolonged resuscitation time and use of vasopressors were independent predictors of worse in-hospital outcome.
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