August 18, 2011

Survival Predictors of Cardiac Arrest

(Ivanhoe Newswire) "“ Cardiac arrest is the leading cause of death in North America. The type of cardiac arrest suffered by patients in intensive care units (ICUs) may predict their long-term survival rate, according to this study.

Researchers from the University of Alberta sought to understand survival rates for people who suffer cardiac arrest in the ICU. They looked at data over a five-year period from four Alberta hospitals with coronary care units and general ICUs, including survival rates at one and five years as well as short-term rates.

The study included 517 patients, with 62% male participants and a mean age of 67 years. Of these, 27% survived to hospital discharge, 24% to one year and 16% to five years. General ICU patients were more likely to die in the ICU compared with coronary care or cardiac surgical ICU patients. Time of day of cardiac arrest did not affect survival to discharge.

Factors associated with a high risk of death after cardiac arrest in the ICU include pulseless electrical activity or asystolic arrest, longer duration of resuscitation and decreased long-term survival with advanced age.

"Although overall survival among ICU patients may have greatly improved, survival among those experiencing cardiac arrest in the ICU, particularly arrest due to pulseless electrical activity or asystole, remained comparatively poor," Dr. Demetrios Kutsogiannis, University of Alberta, with coauthors, were quoted as saying.

"We hope this study will help inform the public about outcomes after arrests in hospital intensive and coronary care units," stated the authors. "It is hoped that improved informed decision-making regarding end-of-life resuscitation attempts may occur between patients, families and their physicians prior to serious illness and potential coronary or ICU care."

Customizing evaluation and treatment of cardiac arrests to better understand the underlying causes and outcomes may help improve patient survival rates.

SOURCE: CMAJ, published online August 2011