PT  - JOURNAL ARTICLE
AU  - Emily Andrew
AU  - Ziad Nehme
AU  - Rory Wolfe
AU  - Stephen Bernard
AU  - Karen Smith
TI  - Long-term survival following out-of-hospital cardiac arrest
AID  - 10.1136/heartjnl-2016-310485
DP  - 2017 Jul 01
TA  - Heart
PG  - 1104--1110
VI  - 103
IP  - 14
4099  - http://heart.bmj.com/content/103/14/1104.short
4100  - http://heart.bmj.com/content/103/14/1104.full
SO  - Heart2017 Jul 01; 103
AB  - Objective Although the factors associated with short-term survival from out-of-hospital cardiac arrest (OHCA) are well established, relatively little is known about the factors that influence long-term survival. In this study, we describe the 15-year survival outcomes of OHCA survivors and examine the influence of peri-arrest factors and 12-month outcomes on long-term survival.Methods Survivors of OHCA between 2000 and 2014 identified from the Victorian Ambulance Cardiac Arrest Registry were linked with state-wide death records. Kaplan-Meier survival curves and Cox regression models were used to estimate long-term survival outcomes.Results A total of 3449 patients were included with a mean survival duration of 11.9 (95% CI 11.7 to 12.1) years. The 1-year survival rate was 92.2% (95% CI 91.3% to 93.1%), while the 5, 10 and 15-year survival rates were 81.4% (95% CI 79.9% to 82.8%), 70.1% (95% CI 67.9% to 72.1%) and 62.3% (95% CI 58.9% to 65.5%), respectively. The standardised mortality rate of OHCA survivors was 5.6 times that of the standard Australian population in the first-year postarrest, but approached that of the standard population 5 years postarrest. Few peri-arrest factors were independently associated with long-term survival after discharge. Rather, transport to a percutaneous coronary intervention-capable hospital and discharge home from hospital were associated with longevity. Returning to work and favourable physical/functional recovery were associated with improved survival after 12 months.Conclusions OHCA survivors experience relatively favourable long-term survival after discharge from hospital. While peri-arrest factors had little influence on long-term survival after hospital discharge, favourable recovery postdischarge was associated with improved long-term outcomes.