Neurological outcome and modifiable events after out-of-hospital cardiac arrest in patients managed in a tertiary cardiac centre: A ten years register

AbstractObjectiveA study was made of the events occurring in the early post-resuscitation phase that may help to improve the outcomes at hospital discharge.DesignA retrospective cohort study (2007–2017) of a prospective Utstein type registry database was carried using multivariate logistic regression analysis. Pre- and post-hospital admission events were investigated.SettingA tertiary cardiac centre.ParticipantsUnconscious victims of out-of-hospital cardiac arrest (OHCA) with documented ventricular tachycardia or fibrillation.Main variables of interestEvents occurring before and within 72 h after intensive care unit (ICU) admission were recorded. The variables were analyzed to determine their impact on hospital survival and poor neurological outcome. One-year follow-up survival was also considered. Results are presented as odds ratio (OR) and 95% confidence interval (95%CI). ResultsOf 245 patients admitted to our ICU after OHCA, 152 (62%) were alive and 131 (86.2%) presented good neurological outcomes (cerebral performance categories ≤ 2) at hospital discharge. The one-year follow-up survival rate was 95.9%. Age >70 years (OR 2.0; 95%CI 1.1–4.1), previous myocardial infarction (OR 2.7; 95%CI 1.2–6.1), shock upon hospital admission (OR 2.9; 95%CI 1.3–6.2), time from call to return of spontaneous circulation (ROSC) >25 min (OR 3.1; 95%CI 1.6–6.0) and anticonvulsant therapy (OR 18.2; 95%CI 5.5–60) were independent predictors of poor neurological outcome. Immediate admission to the cardiac centre (OR 0.5; 95%CI 0.3–0.9) and lactate clearance reaching plasma levels