title: Long-term mortality among patients discharged alive after out-of-hospital cardiac arrest does not differ markedly compared with that of myocardial infarct patients without out-of-hospital cardiac arrest.
abstract: The aim of our research was to study the long-term prognosis among patients discharged alive after an out-of-hospital cardiac arrest (OHCA) in comparison with patients discharged alive after acute myocardial infarction (AMI) without OHCA, and also to study the long-term influence of AMI in connection with OHCA. Our research was conducted in the municipality of Göteborg. We retrospectively studied patients discharged from hospital 1990-91 after an OHCA of cardiac aetiology and patients discharged after an AMI without prehospital cardiac arrest. During 1980-98, we studied all patients discharged alive after OHCA of cardiac aetiology, divided into groups of precipitating AMI and no AMI. The study includes 48 patients discharged alive after an OHCA 1990-91, 30 (62%) of whom had a simultaneous AMI and 1425 patients with an AMI without OHCA. Compared with AMI survivors, survivors of an OHCA of cardiac origin were younger but had more frequently a history of congestive heart failure. Their mortality rate during the subsequent 5 years was 46%, compared with 40% among survivors of an AMI (NS). The 5-year mortality rate among patients with an OHCA precipitated by an AMI was 40%. When correcting for differences at baseline, the adjusted risk ratio for death among patients with an OHCA of cardiac origin was 1.2 (95% CI 0.8-1.8) compared with patients with an uncomplicated AMI. During 1980-98, 215 patients were judged as having an OHCA precipitated by an AMI and 115 patients had an OHCA of cardiac aetiology but no simultaneous AMI. Five-year mortality was 54% and 50% respectively (NS). It is concluded that survivors of an OHCA of cardiac origin differed from survivors of an uncomplicated AMI in that they were younger and more frequently had a history of cardiovascular disease. Their 5-year mortality after discharge was similar to that of survivors of an AMI without a prehospital cardiac arrest, even after adjusting for differences at baseline.
authors.affiliation: Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Engdahl
authors.forename: A
authors.initials: A
authors.lastname: Bång
authors.forename: B W
authors.initials: BW
authors.lastname: Karlson
authors.forename: J
authors.initials: J
authors.lastname: Lindqvist
authors.forename: M
authors.initials: M
authors.lastname: Sjölin
authors.forename: J
authors.initials: J
authors.lastname: Herlitz
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D002317:Cardiovascular Agents / Q000627:therapeutic use; D003071:Cognition; D015897:Comorbidity; D005260:Female; D006323:Heart Arrest / Q000188:drug therapy / Q000201:enzymology / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000201:enzymology / Q000401:mortality*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011379:Prognosis; D012189:Retrospective Studies; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D013995:Time
chemical_list: D002317:Cardiovascular Agents