title: Two-year survival and neurological outcome of in-hospital cardiac arrest patients rescued by extracorporeal cardiopulmonary resuscitation.
abstract: BACKGROUND
  The clinical benefit of extracorporeal cardiopulmonary resuscitation (E-CPR) has been proved in short-term follow-up studies. However, the benefit of E-CPR beyond 1 year has been not known. We investigated 2-year outcome of patients who received E-CPR or conventional CPR (C-CPR).
  
  
  METHODS
  We analyzed a total of 406 adult in-hospital cardiac arrest victims who underwent CPR for more than 10 min from 2003 to 2009. The two-year survival and neurological outcome of E-CPR (n=85) and C-CPR (n=321) were compared using propensity score-matched analysis.
  
  
  RESULTS
  The 2-year survival with minimal neurological impairment was 4-fold higher in the E-CPR group than the C-CPR group (23.5% versus 5.9%, hazard ratio (HR)=0.57, 95% confidence interval (CI)=0.43-0.75, p<0.001) by unadjusted analysis. After propensity-score matching, it was still 4-fold higher in the E-CPR group than the C-CPR group (20.0% versus 5.0%, HR=0.53, 95% CI=0.36-0.80, p=0.002). In the E-CPR group, the independent predictors associated with minimal neurological impairment were age ≤65 years (HR=0.46; 95% CI=0.26-0.81; p=0.008), CPR duration ≤35 min (HR=0.37; 95% CI=0.18-0.76; p=0.007), and subsequent cardiovascular intervention including coronary intervention or cardiac surgery (HR=0.36; 95% CI=0.18-0.68; p=0.002).
  
  
  CONCLUSIONS
  The initial survival benefit of E-CPR for cardiac arrest patients persisted at 2 years.
authors.affiliation: Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Tae Gun
authors.initials: TG
authors.lastname: Shin
authors.forename: Ik Joon
authors.initials: IJ
authors.lastname: Jo
authors.forename: Min Seob
authors.initials: MS
authors.lastname: Sim
authors.forename: Yong-Bien
authors.initials: YB
authors.lastname: Song
authors.forename: Jung-Hoon
authors.initials: JH
authors.lastname: Yang
authors.forename: Joo-Yong
authors.initials: JY
authors.lastname: Hahn
authors.forename: Seung Hyuk
authors.initials: SH
authors.lastname: Choi
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
authors.forename: Eun-Seok
authors.initials: ES
authors.lastname: Jeon
authors.forename: Kiick
authors.initials: K
authors.lastname: Sung
authors.forename: Young Tak
authors.initials: YT
authors.lastname: Lee
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000639:trends*; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000639:trends; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000401:mortality* / Q000628:therapy*; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis* / Q000401:mortality / Q000517:prevention & control; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiac arrest; cardiopulmonary resuscitation; extracorporeal circulation; long term follow-up; outcomes