title: Predictors for outcome among cardiac arrest patients: the importance of initial cardiac arrest rhythm versus time to return of spontaneous circulation, a retrospective cohort study.
abstract: BACKGROUND
  In the past decade, early treatment of cardiac arrest (CA) victims has been improved in several ways, leading to more optimistic over all prognoses. However, the global survival rate after out-of-hospital CA (OHCA) is still not more than 5-10%. With a better knowledge of the predictors for outcome among CA patients, we can improve the management of CA, in order to strengthen the leads in the chain of survival.
  
  
  METHODS
  A retrospective cohort study including 172 CA patients admitted to the intensive care unit (ICU) in Odense University Hospital (OUH) in a three-year period was conducted. We determined the 90-day mortality and neurological outcome at discharge for CA patients treated with therapeutic hypothermia (TH), in regard to determine the importance of the predictors for mortality and neurological outcome, with emphasize on combining initial rhythm and time to return of spontaneous circulation (ROSC).
  
  
  RESULTS
  The overall mortality was 44% and a favorable neurological outcome was seen among 52%. Strong predictors for survival and favorable neurological outcome were ventricular tachycardia/ventricular fibrillation (VT/VF) as initial rhythm, cardiac etiology and time to ROSC < 20 minutes. Age < 60 years was a predictor for survival only. Patients with the combination of VT/VF and ROSC < 20 minutes had undeniably the best chance of both survival and a favorable neurological outcome.
  
  
  CONCLUSIONS
  We found significant predictors for both survival and neurological outcome, in which an initial rhythm of VT/VF and a cardiac etiology were the strongest.
authors: Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark. ida.wibrandt@gmail.com.
authors: Ida
authors: I
authors: Wibrandt
authors: Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark. knorsted@gmail.com.
authors: Kristine
authors: K
authors: Norsted
authors: Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark. henrik.schmidt@rsyd.dk.
authors: Henrik
authors: H
authors: Schmidt
authors: Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark. jens.schierbeck@rsyd.dk.
authors: Jens
authors: J
authors: Schierbeck
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D017180:Tachycardia, Ventricular / Q000209:etiology; D013997:Time Factors; D014693:Ventricular Fibrillation / Q000209:etiology; D055815:Young Adult
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