Patients who experienced the loss of pulses after the successful return of spontaneous circulation were more likely to die at hospital discharge, researchers reported here.
Based on case data from the Resuscitation Outcomes Consortium, patients who had unresolved prehospital re-arrest after an out-of-hospital cardiac arrest had greater than six-fold odds of death prior to hospital discharge (OR 6.14, 95% CI 4.32 to 8.75, P<0.001), according to David Salcido, MPH, of the University of Pittsburgh School of Medicine in Pennsylvania, and colleagues.
While the incidence of re-arrest was relatively uncommon in this study population, survival was 7.8% among cases of unresolved pre-hospital re-arrest versus 33.3% in cases without, Salcido reported at the American Heart Association meeting. The overall survival to hospital discharge was 28%.
The results are preliminary, but the take-home message is that patient resuscitation does not necessarily mean "they're of the woods completely. Re-arrest is real and strongly predictive of death," Salcido told MedPage Today.
The phenomenon of re-arrest is important because even transient loss of pulses prior to hospital arrival may have a detrimental impact on patient outcomes, the authors explained.Patients who experience re-arrest may also demonstrate specific pathology, the identification and treatment of which may lead to better outcomes, they added.
The group analyzed 11,456 out-of-hospital cardiac arrest cases from 2006 to 2008 from a 10-site cardiac arrest surveillance program, which included patients treated with successful return of spontaneous circulation by nontraumatic emergency medical services.
06/11/2012 : By Cole Petrochko / MedPage Today.
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