SPC365

Out-of-Hospital Cardiac Arrest: Epidemiology, ICU Outcomes, and Prognostic Insights

Session: Sessão de Posters 04 - Choque cardiogénico
Speaker: Marta Miguez Vilela

Congress: CPC 2024
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 14. Acute Cardiac Care
Subtheme: 14.5 Acute Cardiac Care – Cardiac Arrest
Session Type: Cartazes
FP Number: ---
Authors: Marta Miguez De Freitas Vilela; Diogo Rosa Ferreira; Ana Abrantes; Miguel Azaredo Raposo; Catarina Gregório; Catarina Simões de Oliveira; Ana Margarida Martins; Ana Beatriz Garcia; Carolina Robalo; João Ribeiro; Fausto Pinto; Doroteia Silva

<p style="text-align:start"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Introduction:</strong><br />
<span style="background-color:white">Out-of-hospital cardiac arrest (OHCA) is a global leading cause of death, challenging public health policies. The difficulty lies in obtaining comprehensive epidemiological data on OHCA patients, with literature varying widely in terms of incidence, patient characteristics, and outcomes.</span></span></span></span></p>

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<p><span style="color:#000000"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><strong><span style="background-color:white">Purpose: </span></strong><span style="background-color:white">Characterize the population and outcomes of OHCA.</span></span></span></span></p>
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<p style="text-align:start"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong>Methods: </strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:white">Retrospective, observational, single-center study on patients admitted to an ICU unit of a tertiary hospital following OHCA between 2017 and 2019.&nbsp; Data was collected from clinical registries. Follow-up was obtained by contacting the surviving patients or families.</span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong><span style="background-color:white">Results: </span></strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:white">Out of the 78 patients included in the study, 32.9% were female, exhibiting an average age of 59.3&plusmn;15.1. Only two patients had a history of family sudden death.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:white">The most common arrest sites were at home (39,2%) and at the street (20,3%). A significant proportion of OHCA were observed by witnesses (84.8%), and basic life support was provided in 72.2% of instances. Notably, only 25.3% of these interventions incorporated the use of an automated external defibrillator. Mean no-flow time was 4.1&plusmn;3.1 minutes and low-flow-time was 22.7&plusmn;12.3 minutes. 51,9% had a shockable rhythm. Arrest rhythm is displayed in Chart 1 and cause of OHCA in Table 1. Out of the patients with a cardiac cause, 50,9% were due to acute coronary syndrome. Mean left ventricle ejection fraction at 48 hours was 38.9&plusmn;14,2%.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:white">A total of 59 patients (74.7%) died during follow-up (FUP). Mean FUP time in surviving patients was 3.9 years. The majority of the patients died in the ICU (57%) and 67,1% during hospital stay. The main cause of death was anoxic encephalopathy (55,7%).</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:white">Neuroprognostication applied to 79.7% revealed: 71.2% considered deceased, 15.2% recovered (Glasgow Coma Score &gt; 9), and 6.3% had unclear prognosis. Of 5 unclear cases, 4 died during admission. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:white">Regarding neurological outcomes, the cerebral performance category (CPC) was calculated. At discharge from ICU the median CPC was 2 and 1 at discharge from hospital. Median CPC at follow-up was 1 and median ECOG performance status was 2. Two patients had a CPC score of 4 at FUP.</span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><strong><span style="background-color:white">Conclusion:</span></strong></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:white">This study reveals that our survival rate aligns with previously documented rates in the literature. Our results emphasize that the prognosis for these patients is established early in the hospital admission process. Those who survive until discharge exhibit a positive prognosis, often without significant neurological impairment</span>.</span></span></span></p>