Predicting factors for long-term survival in patients with out-of-hospital cardiac arrest – A propensity score-matched analysis
Lahmann AL, Bongiovanni D, Berkefeld A, Kettern M, Martinez L, Okrojek R, Hoppmann P, Laugwitz KL, Mayr P, Cassese S, Byrne R, Kutner S, Xhepal E, Schunkert H, Kastrati A, Joner M (2020)
Publication Type: Journal article
Publication year: 2020
Journal
Book Volume: 15
Article Number: e0218634
Journal Issue: 1
DOI: 10.1371/journal.pone.0218634
Abstract
Background Out-of-hospital cardiac arrest (OHCA) is one of the leading causes of death worldwide, with acute coronary syndromes accounting for most of the cases. While the benefit of early revascularization has been clearly demonstrated in patients with ST-segment-elevation myocardial infarction (STEMI), diagnostic pathways remain unclear in the absence of STEMI. We aimed to characterize OHCA patients presenting to 2 tertiary cardiology centers and identify predicting factors associated with survival. Methods We retrospectively analyzed 519 patients after OHCA from February 2003 to December 2017 at 2 centers in Munich, Germany. Patients undergoing immediate coronary angiography (CAG) were compared to those without. Multivariate regression analysis and inverse probability treatment weighting (IPTW) were performed to identify predictors for improved outcome in a matched population. Results Immediate CAG was performed in 385 (74.1%) patients after OHCA with presumed cardiac cause of arrest. As a result of multivariate analysis after propensity score matching, we found that immediate CAG, return of spontaneous circulation (ROSC) at admission, witnessed arrest and former smoking were associated with improved 30-days-survival [(OR, 0.46; 95% CI, 0.26–0.84), (OR, 0.21; 95% CI, 0.10–0.45), (OR, 0.50; 95% CI, 0.26–0.97), (OR, 0.43; 95% CI, 0.23–0.81)], and 1-year-survival [(OR, 0.39; 95% CI, 0.19–0.82), (OR, 0.29; 95% CI, 0.12–0.7), (OR, 0.43; 95% CI, 0.2–1.00), (OR, 0.3; 95% CI, 0.14–0.63)]. Conclusions In our study, immediate CAG, ROSC at admission, witnessed arrest and former smoking were independent predictors of survival in cardiac arrest survivors. Improvement in prehospital management including bystander CPR and best practice post-resuscitation care with optimized triage of patients to an early invasive strategy may help ameliorate overall outcome of this critically-ill patient population.
Involved external institutions
Germany (DE)How to cite
APA:
Lahmann, A.L., Bongiovanni, D., Berkefeld, A., Kettern, M., Martinez, L., Okrojek, R.,... Joner, M. (2020). Predicting factors for long-term survival in patients with out-of-hospital cardiac arrest – A propensity score-matched analysis. PLoS ONE, 15(1). https://doi.org/10.1371/journal.pone.0218634
MLA:
Lahmann, Anna Lena, et al. "Predicting factors for long-term survival in patients with out-of-hospital cardiac arrest – A propensity score-matched analysis." PLoS ONE 15.1 (2020).
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