LONG-TERM PROGNOSIS AFTER OUT-OF-HOSPITAL CARDIAC ARRESTS WITH/WITHOUT ST ELEVATION MYOCARDIAL INFARCTION

Aim: To describe three-year survival patients after out-of-hospital cardiac arrest (OHCA) with a view to analysis survival by present ST-segment elevation myocardial infarction (STEMI) and at the same time evaluate prognostic factors in pre-hospital and hospital care.
Patient group: Over a period of 29 months we prospectively included, with the aid of a questionnaire supplied to 24 rescue stations, 560 individuals (415 men; aged 16-97 years, median 68) in whom cardiopulmonary resuscitation (CPR) for OHCA of confirmed cardiac etiology was attempted.
Results: In 149 hospitalized individuals after OHCA survived one year 28.2 % and three years 25.5%. At 26 individuals (17.5%) was diagnosed STEMI after admission to a hospital. In subgroup of patients with STEMI survived one year 57.7% and three years 53.9%. In subgroup of patients without STEMI (n=123) survived one year 22% and three years 19.5%. The most main predictors of long-term survival by logistic regression analysis were: age under 70 years, ventricular fibrillation as initial rhythm, CPR without atropine and STEMI. Indicator of better survival in subgroup with STEMI was occurrence OHCA at public place. In subgroup of patients without STEMI were positively affected long-term   angiotensin-converting enzyme inhibitor treatment, CPR without atropine, Glasgow Coma Scale on hospital admission over 3, no progress of cardiogenic shock and no manifestation of postanoxic encephalopathy  (Fisher’s exact test, χ2 test).
Conclusion: In 560 individuals with “primary cardiac” etiology OHCA and initiated professional CPR survived one year 8% and three years 7% of all. Higher survival patients with STEMI were documented.