Article Text

Download PDFPDF

72 Out-of-hospital cardiac arrest survivors undergoing emergency PCI have an excellent neurological recovery
Free
  1. liandra rams ramachenderam1,
  2. Anthony Mechery2,
  3. Peter Isherwood3,
  4. Neil Abeysinghe3,
  5. Alexander Zaphiriou3,
  6. Sudhakar George3,
  7. M. Adnan Nadir2,
  8. Peter Ludman2,
  9. Sagar Doshi2,
  10. Jonathan Townend2,
  11. sohail khan2
  1. 1University of Birmingham
  2. 2Queen Elizabeth Hospital Birmingham
  3. 3University Hospital Birmingham

Abstract

Introduction Out-of-hospital cardiac arrest (OHCA) is associated with a low survival to discharge rate. We aimed to evaluate the outcome of early Percutaneous Coronary Intervention (PCI) on the mortality rates of patients with OHCA and their neurological recovery post-intervention.

Methods Outcomes of all patients presenting to our centre with OHCA who received PCI over a 3-year period were analysed (January 2015 - December 2017). Univariate analysis was performed.

Results 65 patients were identified (80% Males, Mean age 59.9 ± 14.2 years). Chest compressions were undertaken in 60.0% of patients. The most common rhythm identified was Ventricular Fibrillation (86.2%), followed by PEA (9.2%), Ventricular Tachycardia (4.6%) and Asystole (4.6%). The mean time for patients to arrive at the cardiac centre was 51.4± 20.7 minutes. Post-arrest ECG revealed ST-elevation (STEMI) in 53 (81.5%) patients. 42 (64.4%) received ventilation pre-angiography and 45 (69.2%) were transferred to Intensive Care Unit (ITU) post-angiography. 18 (27.7%) were in cardiogenic shock. There was no statistical significance in the mortality rates between patients with STEMI and non-STEMI (53 vs 12; p=0.43), see Table 1. 54 patients (83.1%) survived to discharge, 30-day survival 53(81.6%), 6-month survival 53(81.6%). 31 ventilated patients (73.8%) survived to discharge, 30-days and 6-months whereas all (100%) non-ventilated patients (n=23) survived to discharge and 30-days and 22 survived (95.7%) at 6-months (73.8 vs 100%; p=0.04). 12 patients in shock (66.7%) survived to discharge, 30-days and 6-months whereas 42 non-shocked patients (89.4%) survived to discharge, 30-days and 6-months (66.7 vs 89.4%, p=0.06). Cerebral Performance Category (CPC) score at 30-days was as follows; 48 (73.8%) scored 1, 3 (4.6%) scored 2, 2 (3.1%) scored 3, 1 (1.5%) scored 4 and 11 (16.9%) scored 5. Significantly more patients were in CPC 1 to 3 than 4–5 (53 vs 12; p<0.001), see Table 2.

Abstract 72 Table 1

Conclusion In our cohort of patients presenting with OHCA who underwent PCI, we observed an excellent survival to discharge rate. Poor neurological recovery is seen in only a minority of patients who have received PCI after successful OHCA.

Conflict of Interest None

  • Out-of-hospital Cardiac Arrest (OHCA)
  • ST-elevation MI
  • Percutaneous Coronary Intervention (PCI)

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.