Early left ventricular ejection fraction as a predictor of survival after cardiac arrest.
BACKGROUND
Cardiopulmonary resuscitation and early defibrillation have been shown to improve outcomes of cardiac arrest. The significance of the post-arrest echocardiogram, specifically the left ventricular ejection fraction (LVEF) is unknown.


METHODS
We performed a retrospective cohort study of patients who suffered from cardiac arrest between 1 January 2009 and 31 December 2013. We included all patients who achieved return of spontaneous circulation (ROSC), and were admitted to the intensive care unit (ICU) or coronary care unit (CCU) of a tertiary care academic center. Patients who underwent echocardiography within 24 h of cardiac arrest were included for analysis. The primary outcome was survival.


RESULTS
We identified 151 patients who achieved ROSC of which 97 underwent post-arrest echocardiogram within 24 h. 70.8% were males and the mean age was 67.8 years (SD: 15.9). The mean LVEF at 24 h was 35.7 (SD: 17.8). LVEF > 40% was not a predictor of survival at 30 days or hospital discharge. The only significant predictors on multivariate analyses were age, presence of shockable rhythm and time to ROSC.


CONCLUSIONS
Although echocardiograms are frequently ordered, LVEF greater than 40% in patients who are resuscitated after a cardiac arrest is not a predictor of survival.
a Division of Cardiology , McGill University , Montreal , Quebec , Canada.
Barry
B
Burstein
b Department of Critical Care , McGill University Health Center and Jewish General Hospital, McGill University , Montreal , Quebec , Canada.
Dev
D
Jayaraman
c Division of Cardiology , Jewish General Hospital, McGill University , Montreal , Quebec , Canada.
Regina
R
Husa
D000368:Aged; D002170:Canada / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation / Q000379:methods / Q000401:mortality; D004452:Echocardiography / Q000379:methods*; D004554:Electric Countershock / Q000379:methods / Q000401:mortality; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013318:Stroke Volume; D016019:Survival Analysis; D016896:Treatment Outcome; D016277:Ventricular Function, Left
Cardiac arrest; echocardiography; left ventricular function