[Post-anoxic encephalopathy after an episode of aborted sudden cardiac death].
OBJECTIVE
The presence of post-anoxic encephalopathy after an episode of aborted sudden cardiac death is a serious medical and social problem.


METHODS
Of 193 patients admitted to the coronary unit during a 12-year period with aborted sudden cardiac death, 104 died (54%) and 89 survived the episode (46%). We compared the characteristics and 6-month prognosis between survivors according to the presence or absence of post-anoxic encephalopathy.


RESULTS
Of 89 survivors, 38 patients were discharged alive with post-anoxic encephalopathy (42%) and 51 were discharged without neurological disturbances (58%). Patients with post-anoxic encephalopathy were older (65 13.6 vs. 59 12.9 years; p = 0.04). Mean time to care for cardiac arrest was 11.14.9 min in the post-anoxic encephalopathy group, versus 3.43 min (p < 0.01). The first documented rhythm was VF/VT in 57% and asystolia in 29% in the post-anoxic encephalopathy group, vs. 88% and 3% (p = 0.02). More than half (58%) of the patients in the post-anoxic encephalopathy group had coronary artery disease, vs. 49% (p = NS). Slightly more than half (52%) of the patients in the post-anoxic encephalopathy group had infectious complications, vs. 21% (p = 0.01). After 6 months of follow-up, mortality in patients discharged with post-anoxic encephalopathy was 62%, vs. 10% (p < 0.01); 21% of then showed significant functional improvement and 18% remained neurologically stable.


CONCLUSIONS
Most patients admitted to a coronary unit with aborted sudden cardiac death died during hospitalization. Almost half of the survivors had post-anoxic encephalopathy at discharge; of these patients, 62% died within the following 6 months, and functional status improved only in a minority of them.
Gómez
Miquel
M
Servicio de Cardiología. Hospital Universitari Germans Trias i Pujol. Badalona. Barcelona. España. miguelgomez@comb.es
Serra
Jordi
J
Curós
Antoni
A
Claver
Eduard
E
Rodríguez-Leor
Oriol
O
Bernal
Eva
E
Valle
Vicente
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000401:mortality; D003645:Death, Sudden / Q000209:etiology*; D005260:Female; D006323:Heart Arrest / Q000150:complications* / Q000401:mortality / Q000628:therapy; D006801:Humans; D002534:Hypoxia, Brain / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome