Min Jung Kim1, Young Sun Ro2, Sang Do Shin3, Kyoung Jun Song4, Ki Ok Ahn5, Sung Ok Hong6, Young Taek Kim7. 1. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, Republic of Korea. Electronic address: minkim229@gmail.com. 2. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, Republic of Korea. Electronic address: Ro.youngsun@gmail.com. 3. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: shinsangdo@medimail.co.kr. 4. Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: skciva@gmail.com. 5. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, 101 Daehak-Ro, Jongno-Gu, Seoul 110-744, Republic of Korea. Electronic address: arendt75@gmail.com. 6. Korea Centers for Disease Control and Prevention, Chungbuk, Republic of Korea. Electronic address: soh822@hanmail.net. 7. Korea Centers for Disease Control and Prevention, Chungbuk, Republic of Korea. Electronic address: ruyoung@cdc.go.kr.
Abstract
BACKGROUND: It is unclear whether the benefits of post-resuscitative percutaneous coronary intervention (PCI) are equally observed across out-of-hospital cardiac arrests (OHCAs) with different clinical presentations. The purpose of this study was to assess the effect of PCI in outcomes of OHCA and to compare patient prognosis by history of heart disease (HD) and presentations of nonshockable vs. shockable arrest rhythm by electrocardiogram (ECG). METHODS: A population-based observational study was conducted on OHCAs of cardiac etiology in Korea who survived to admission between 2009 and 2013. Multivariable logistic regression analyses were conducted to assess the associations between PCI and outcomes (favorable neurological outcome and survival-to-discharge) and to test the interaction effects of PCI with history of HD and with presence of shockable rhythm. RESULTS: A total of 9762 OHCAs were analyzed. PCI was done in 1140 (11.7%), and neurological recovery were observed in 45.7% of the PCI group and 13.3% of the untreated group. Effects of PCI on neurological recovery were observed similarly in patients with and without history of HD (OR=2.33 (1.62-3.35) and OR=2.37 (1.95-2.89), respectively). PCI was associated with survival-to-discharge only in patients without history of HD (OR=1.80 (1.51-2.15)). PCI was associated with neurological recovery and survival-to-discharge in both shockable and nonshockable rhythms, although the estimates were relatively higher in those with nonshockable rhythms (OR for neurological recovery=2.60 (2.04-3.32); and OR for survival=1.78 (1.46-2.17)). CONCLUSIONS: This study corroborates that PCI is an advantageous treatment option for all patients with OHCA regardless of established diagnosis with HD and presentations of shockable rhythm.
BACKGROUND: It is unclear whether the benefits of post-resuscitative percutaneous coronary intervention (PCI) are equally observed across out-of-hospital cardiac arrests (OHCAs) with different clinical presentations. The purpose of this study was to assess the effect of PCI in outcomes of OHCA and to compare patient prognosis by history of heart disease (HD) and presentations of nonshockable vs. shockable arrest rhythm by electrocardiogram (ECG). METHODS: A population-based observational study was conducted on OHCAs of cardiac etiology in Korea who survived to admission between 2009 and 2013. Multivariable logistic regression analyses were conducted to assess the associations between PCI and outcomes (favorable neurological outcome and survival-to-discharge) and to test the interaction effects of PCI with history of HD and with presence of shockable rhythm. RESULTS: A total of 9762 OHCAs were analyzed. PCI was done in 1140 (11.7%), and neurological recovery were observed in 45.7% of the PCI group and 13.3% of the untreated group. Effects of PCI on neurological recovery were observed similarly in patients with and without history of HD (OR=2.33 (1.62-3.35) and OR=2.37 (1.95-2.89), respectively). PCI was associated with survival-to-discharge only in patients without history of HD (OR=1.80 (1.51-2.15)). PCI was associated with neurological recovery and survival-to-discharge in both shockable and nonshockable rhythms, although the estimates were relatively higher in those with nonshockable rhythms (OR for neurological recovery=2.60 (2.04-3.32); and OR for survival=1.78 (1.46-2.17)). CONCLUSIONS: This study corroborates that PCI is an advantageous treatment option for all patients with OHCA regardless of established diagnosis with HD and presentations of shockable rhythm.
Authors: Young Sun Ro; Sang Do Shin; Kyoung Jun Song; Joo Yeong Kim; Eui Jung Lee; Yu Jin Lee; Ki Ok Ahn; Ki Jeong Hong Journal: PLoS One Date: 2016-04-22 Impact factor: 3.240