A multiple logistic regression analysis of in-hospital factors related to survival at six months in patients resuscitated from out-of-hospital ventricular fibrillation.
BACKGROUND
The impact of the immediate in-hospital post-resuscitation care after out-hospital cardiac arrest is not well known. Based on treatment variables and laboratory findings a multiple logistic regression model was created for the prediction of survival at 6 months from the event.


METHODS
A retrospective study of the hospital charts of patients successfully resuscitated and treated in one of three community hospitals from 1998 to 2000. In addition to several pre-hospital variables, the mean 72 h values of clinical features such as blood pressure, blood glucose concentration and initiated treatment used, were included in a forward multiple logistic regression model predicting survival at 6 months from the event.


RESULTS
The charts of 98 out of a total of 102 patients were sufficiently complete and included in the analysis. Variables independently associated with survival were age, delay before a return of spontaneous circulation, mean blood glucose and serum potassium, and the use of beta-blocking agents during post-resuscitation care. When those patients who were assigned a 'do not attempt to resuscitate' (DNAR) order during the first 72 h of treatment were excluded from the analysis blood glucose, blood potassium and the use beta-blocking agents remained independently associated with survival.


CONCLUSIONS
This study suggests that in-hospital factors are associated with survival from out-of-hospital cardiac arrest. The mean blood glucose and serum potassium during the first 72 h of treatment and the use of beta-blocking agents were significantly and independently associated with survival.
Skrifvars
M B
MB
Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Hospital, P.O. Box 340, FIN-00029 HUS Helsinki, Finland. markus.skrifvars@kolumbus.fi
Pettilä
V
V
Rosenberg
P H
PH
Castrén
M
M
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000704:Analysis of Variance; D001786:Blood Glucose / Q000032:analysis; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D002423:Cause of Death; D004632:Emergency Medical Services / Q000379:methods*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006323:Heart Arrest / Q000401:mortality* / Q000517:prevention & control; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011188:Potassium / Q000097:blood; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*
D000319:Adrenergic beta-Antagonists; D001786:Blood Glucose; D011188:Potassium