One-Year Survival after Inhospital Cardiac Arrest-Does Prearrest Sepsis Matter?
| Autor: | Olli Arola, Outi Inkinen, Minna Tallgren, Pia Koivikko |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment MEDLINE 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Sepsis 03 medical and health sciences 0302 clinical medicine Epidemiology medicine Humans Cardiopulmonary resuscitation Aged Retrospective Studies ta3126 business.industry 030208 emergency & critical care medicine Retrospective cohort study Multiorgan dysfunction ta3121 Middle Aged medicine.disease Prognosis Cardiopulmonary Resuscitation 3. Good health Heart Arrest Hospitalization Pneumonia Emergency medicine cardiovascular system Emergency Medicine Female business Complication |
| Zdroj: | Shock (Augusta, Ga.). 50(1) |
| ISSN: | 1540-0514 |
| Popis: | Cardiac arrest is not a common complication of sepsis, although sepsis has been recognized as one condition behind cardiac arrest. Our aim was to evaluate the prevalence of sepsis among patients with inhospital cardiac arrest (IHCA), and to determine if sepsis is associated with inferior outcome after IHCA.All consecutive emergency team dispatches in Turku University Hospital in 2011 to 2014 (n = 607) were retrospectively reviewed to identify the patients undergoing cardiopulmonary resuscitation (CPR) for IHCA (n = 301). The patient records were reviewed for the criteria of severe sepsis, organ dysfunction, and chronic comorbidities before IHCA. Outcome was followed for 1 year.The criteria for prearrest severe sepsis were met by 83/301 (28%) of the patients, and 93/301 (31%) had multiorgan dysfunction (3 or more organ systems). The patients with severe sepsis had higher mortality than those without severe sepsis, increasing from 30-day mortalities of 63/83 (76%) and 151/218 (69%), respectively (P = 0.256), to 1-year mortalities of 72/83 (87%) and 164/218 (75%), respectively (P = 0.030). Emergency admission, age, immunosuppression, DM, multiorgan dysfunction, and a nonshockable rhythm were independent predictors of 1-year mortality by multivariate logistic regression analysis. Six out of 83 patients with severe sepsis before IHCA (7%) survived 1 year with good neurological outcome (CPC scale 1).A high proportion of patients with IHCA have sepsis and multiorgan dysfunction, and their prognosis is worse than the prognosis of patients with IHCA in general. |
| Databáze: | OpenAIRE |
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