BACKGROUND: A number of factors have previously been shown to be predictive of survival from out-of-hospital ventricular fibrillation. These include witnessed collapse, prompt initiation of cardiopulmonary resuscitation, early application of defibrillation, and younger age. Arrests occurring away from home are also associated with improved survival. Additionally, hospital mortality after successful resuscitation has been related to a history of congestive heart failure as well as to some of the factors noted above. An association of prearrest comorbidity with outcome has not been systematically evaluated. METHODS AND RESULTS: We define here a comorbidity index, which is constructed from histories of chronic conditions as well as a number of recent symptoms in 282 victims of out-of-hospital VF. This indicator of comorbidity is strongly associated with outcome (P = .004). However, when analyzing a comprehensive set of predictors of survival after out-of-hospital ventricular fibrillation, including the index of comorbidity, we could identify overall only about one fourth of the variation that one might hope to account for. CONCLUSIONS: Comorbidity appears to be an important (but usually overlooked) predictor of survival from out-of-hospital ventricular fibrillation. However, most of the statistical variability in predicting survival remains unexplained when we consider comorbidity in conjunction with previously identified predictors of survival.
BACKGROUND: A number of factors have previously been shown to be predictive of survival from out-of-hospital ventricular fibrillation. These include witnessed collapse, prompt initiation of cardiopulmonary resuscitation, early application of defibrillation, and younger age. Arrests occurring away from home are also associated with improved survival. Additionally, hospital mortality after successful resuscitation has been related to a history of congestive heart failure as well as to some of the factors noted above. An association of prearrest comorbidity with outcome has not been systematically evaluated. METHODS AND RESULTS: We define here a comorbidity index, which is constructed from histories of chronic conditions as well as a number of recent symptoms in 282 victims of out-of-hospital VF. This indicator of comorbidity is strongly associated with outcome (P = .004). However, when analyzing a comprehensive set of predictors of survival after out-of-hospital ventricular fibrillation, including the index of comorbidity, we could identify overall only about one fourth of the variation that one might hope to account for. CONCLUSIONS: Comorbidity appears to be an important (but usually overlooked) predictor of survival from out-of-hospital ventricular fibrillation. However, most of the statistical variability in predicting survival remains unexplained when we consider comorbidity in conjunction with previously identified predictors of survival.
Authors: Heather L Bloom; Irfan Shukrullah; Jose R Cuellar; Michael S Lloyd; Samuel C Dudley; A Maziar Zafari Journal: Am Heart J Date: 2007-05 Impact factor: 4.749
Authors: Creighton W Don; W T Longstreth; Charles Maynard; Michele Olsufka; Graham Nichol; Todd Ray; Nicole Kupchik; Steven Deem; Michael K Copass; Leonard A Cobb; Francis Kim Journal: Crit Care Med Date: 2009-12 Impact factor: 7.598
Authors: J J de Vreede-Swagemakers; A P Gorgels; W I Dubois-Arbouw; J Dalstra; M J Daemen; J W van Ree; R E Stijns; H J Wellens Journal: Heart Date: 1998-04 Impact factor: 5.994
Authors: Joanna Ghobrial; Susan R Heckbert; Traci M Bartz; Gina Lovasi; Erin Wallace; Rozenn N Lemaitre; April F Mohanty; Thomas D Rea; David S Siscovick; Jean Yee; M Sue Lentz; Nona Sotoodehnia Journal: Heart Date: 2016-04-26 Impact factor: 5.994