Higher chance of survival in patients with out-of-hospital cardiac arrest attributed to poisoning.

Autor: Hüser C; Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany; Emergency Department, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany., Baumgärtel M; Department of Pulmonology, Intensive Care Medicine, Paracelsus Medical University, Hospital Nuremberg, Prof.-Ernst-Nathan-Straße 1, 90419 Nuremberg, Germany., Ristau P; Institute for Emergency Medicine, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Building 404, 24105 Kiel, Germany., Wnent J; Institute for Emergency Medicine, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Building 404, 24105 Kiel, Germany; Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Building R3, 24105 Kiel, Germany., Suárez V; Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany; Emergency Department, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany., Hackl MJ; Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany; Emergency Department, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany., Gräsner JT; Institute for Emergency Medicine, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Building 404, 24105 Kiel, Germany; Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Building R3, 24105 Kiel, Germany., Seewald S; Institute for Emergency Medicine, University Hospital Schleswig-Holstein, Arnold-Heller-Straße 3, Building 404, 24105 Kiel, Germany; Department of Anaesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, Building R3, 24105 Kiel, Germany. Electronic address: stephan.seewald@uksh.de.
Jazyk: angličtina
Zdroj: Resuscitation [Resuscitation] 2022 Jun; Vol. 175, pp. 96-104. Date of Electronic Publication: 2022 Mar 11.
DOI: 10.1016/j.resuscitation.2022.03.009
Abstrakt: Aim of the Study: Description and comparison of cohort characteristics and outcome of adult patients with out-of-hospital cardiac arrest (OHCA) attributed to poisoning (P-OHCA) versus patients with OHCA attributed to other medical causes (NP-OHCA).
Methods: We included all patients who received cardiopulmonary resuscitation after OHCA between January 2011 and December 2020 from German emergency medical services with good data quality in the German Resuscitation Registry.
Exclusion Criteria: patients < 18 years of age or OHCA attributed to trauma, drowning, intracranial bleeding or exsanguination.
Results: Patients with P-OHCA (n = 574) were significantly younger compared to NP-OHCA (n = 40,146) (median age of 43 (35-54) years vs. 73 (62-82) years; p < 0.001). Cardiac arrest in P-OHCA patients was significantly less often witnessed by bystanders (41.8 % vs. 66.2 %, p < 0.001). Asystole was the predominant initial rhythm in P-OHCA patients (73.5% vs. 53.7%, p < 0.001) while ventricular fibrillation (VF) and pulseless electrical activity (PEA) were less common (9.2% vs. 25.1% and 16.2 % vs. 20.5%, p < 0.001). P-OHCA had a higher chance of survival with good neurological outcome at hospital discharge (15.2 vs. 8.8 % p < 0.001) and poisoning was an independent protective prognostic factor in multivariate analysis (OR 2.47, 95%-CI [1.71-3.57]). P-OHCA patients with initial PEA survival with good neurological outcome was comparable to initial VF (34.3 % vs. 37.7%).
Conclusion: Patients in the P-OHCA group had a significantly higher chance of survival with good neurological outcome and PEA as initial rhythm was as favourable as initial VF. Therefore, in P-OHCA patients resuscitation efforts should be extended.
Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: PR is the coordinator of the GRR. JW, JTG and SSE are members of the steering committee of the GRR JW received travel grants from ZOLL medical. MH received grants or contracts from the Deutsche Forschungsgemeinschaft (DFG) and the Center for Molecular Medicine Cologne. JTG is the leader of the European Resuscitation Registry and received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events by Weinmann-Emergency, ZOLL, BARD, Fresenius, Corpuls, Braincool. All other authors have nothing to disclose.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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