Survival of 1476 patients initially resuscitated from out of hospital cardiac arrest.
OBJECTIVE
To determine the short and long term outcome of patients admitted to hospital after initially successful resuscitation from cardiac arrest out of hospital.


METHODS
Review of ambulance and hospital records. Follow up of mortality by "flagging" with the registrar general. Cox proportional hazards analysis of predictors of mortality in patients discharged alive from hospital.


METHODS
Scottish Ambulance Service and acute hospitals throughout Scotland.


METHODS
1476 patients admitted to a hospital ward, of whom 680 (46%) were discharged alive.


METHODS
Survival to hospital discharge, neurological status at discharge, time to death, and cause of death after discharge.


RESULTS
The median duration of hospital stay was 10 days (interquartile range 8-15) in patients discharged alive and 1 (1-4) day in those dying in hospital. Neurological status at discharge in survivors was normal or mildly impaired in 605 (89%), moderately impaired in 58 (8.5%), and severely impaired in 13 (2%); one patient was comatose. Direct discharge to home occurred in 622 (91%) cases. The 680 discharged survivors were followed up for a median of 25 (range 0-68) months. There were 176 deaths, of which 81 were sudden cardiac deaths, 55 were non-sudden cardiac deaths, and 40 were due to other causes. The product limit estimate of 4 year survival after discharge was 68%. The independent predictors of mortality on follow up were increased age, treatment for heart failure, and cardiac arrest not due to definite myocardial infarction.


CONCLUSIONS
About 40% of initial survivors of resuscitation out of hospital are discharged home without major neurological disability. Patients at high risk of subsequent cardiac death can be identified and may benefit from further cardiological evaluation.
Cobbe
S M
SM
Department of Medical Cardiology, Glasgow Royal Infirmary.
Dalziel
K
K
Ford
I
I
Marsden
A K
AK
D000367:Age Factors; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D004632:Emergency Medical Services; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D006333:Heart Failure / Q000150:complications; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D011379:Prognosis; D016016:Proportional Hazards Models; D012151:Resuscitation; D012606:Scotland / Q000453:epidemiology; D015996:Survival Rate; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics