BASELINE CHARACTERISTICS AND DETERMINANTS OF SURVIVAL IN PATIENTS AFTER OUT-OF-HOSPITAL CARDIAC ARREST

Objective: The aim was to identify variables significantly related to survival/mortality of patients transferred after out-of-hospital (OHCA) to the coronary care unit (CCU).

Methods: 102 consecutive patients, mean age 64,6 (SD 13,3), 70,6% men, who suffered from OHCA between 1/2011-12/2013 and transferred directly to the CCU of tertiary care institution, was analyzed. Assessment of basic quantitative and qualitative parameters, survival analysis and between-subgroups comparison was performed.

Results: Cardiac cause of OHCA was in 84 patients (82,4%). From these 60,7% had an acute coronary syndrome (ACS), STEMI in 35,7%, NSTEMI in 23,8%. ACS was more frequent in men (p=0,021) and in patients without prior history of arrhythmia (p=0,005). Coronary angiography was performed in 73 (71,6%) of all patients after OHCA - in 81% with cardiac cause and in 5 of 16 patients (31,3%) with non-cardiac cause. Percutaneus coronary intervention followed in 50 patients (68,5%), 49 of them with cardiac cause, and was successful in 92% of cases. In-hospital mortality was 38,2% and one-year mortality was 51,5%. No statistically significant difference in survival was found in comparison of cardiac and non-cardiac cause. In-hospital survival was significantly related to the age (p=0,002), first ECG rhythm (p=0,001), history of coronary artery disease (CAD) [RR 2,1;95% CI: 1,11-3,95;p=0,026] and history of arrhythmia [RR 2,74;95% CI: 1,47-5,11;p=0,003]. One-year survival was significantly related to the age (p=0,001), first ECG rhythm (p=0,005), history of CAD [RR 1,71;95% CI: 1,09-2,68;p=0,029], history of diabetes mellitus (DM) [RR 1,89;95% CI: 1,24-2,89;p=0,006] and history of arrhythmia [RR 2,3;95% CI: 1,52-3,48;p=0,001].

Conclusion: Age and morbidity have an impact on patients´ survival after OHCA. Diseases such as CAD, DM and even history of arrhythmia signify worse outcome.