title: Long-term survival after successful out-of-hospital resuscitation.
abstract: Between 1983 and 1989, 962 patients in Rotterdam were resuscitated outside hospital, of whom 240 (25%) could be discharged alive. A follow-up study was performed to determine prognosis in these patients. Of the 240 survivors of out-of-hospital resuscitation 80% survived after 1 year and 61% after 5 years. During the first year, 9% suffered from myocardial (re)infarction and 13% underwent coronary bypass surgery or angioplasty. Within the first 3 years after resuscitation 60% of the patients were readmitted to hospital. Permanent or temporary neurological deficits were observed in 30 patients (14%). Patients with a primary arrhythmia without myocardial infarction had a worse prognosis than patients with a cardiac arrest in the context of an infarct. Survival was better in patients in whom resuscitation was initiated by physicians or ambulance-nurses, than in patients resuscitated by lay-people. Multivariate analysis revealed that this difference could be explained by a larger proportion of patients with a primary arrhythmia in the latter group. Since long-term prognosis after out-of-hospital resuscitation is satisfactory, programmes for resuscitation courses should be stimulated. Such programmes should aim predominantly at relatives of patients with known heart disease, police officers and children.
authors.affiliation: Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.
authors.forename: G P
authors.initials: GP
authors.lastname: Kimman
authors.forename: E M
authors.initials: EM
authors.lastname: Ivens
authors.forename: J A
authors.initials: JA
authors.lastname: Hartman
authors.forename: H N
authors.initials: HN
authors.lastname: Hart
authors.forename: M L
authors.initials: ML
authors.lastname: Simoons
mesh_terms: D004632:Emergency Medical Services; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D011379:Prognosis; D012151:Resuscitation; D015996:Survival Rate