Hospital mortality after out-of-hospital cardiac arrest among patients found in ventricular fibrillation

• Published in: Resuscitation 1995-02, Vol.29 (1), p.11-21
• Main Authors: Herlitz, J., Ekström, L., Wennerblom, B., Axelsson, Å., Bång, A., Holmberg, S.
• Format: Article
• Language: English
• Subjects: 80 and over; Adolescent; Adult; Aged; Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Cardiology and Cardiovascular Disease; Cause of Death; Child; complications; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Emergency Medical Services; Female; Heart Arrest; Heart Arrest - complications; Heart Arrest - mortality; Heart Arrest - therapy; Hospital Mortality; Hospitalization; Humans; In-hospital mortality; Intensive care medicine; Kardiologi och kardiovaskulära sjukdomar; Male; Medical sciences; Middle Aged; mortality; Multivariate Analysis; Out of hospital cardiac arrest; Resuscitation; therapy; Ventricular Fibrillation; Ventricular Fibrillation - complications; Ventricular Fibrillation - mortality
• ISSN: 0300-9572; 1873-1570; 1873-1570
• DOI: 10.1016/0300-9572(94)00811-S

The aim of this study was to describe factors associated with in-hospital mortality among patients being hospitalised after out-of-hospital cardiac arrest and who were found in ventricular fibrillation. The study was set in the community of Göteborg, Sweden. The subjects consisted of all patients who were hospitalised alive after out-of-hospital cardiac arrest, being reached by our mobile coronary care unit and who were found in ventricular fibrillation, between 1981 and 1992. In all, 488 patients fullfilled the inclusion criteria of which 262 (54%) died during initial hospitalization. In a multivariate analysis including age, sex, history of cardiovascular disease, chronic medication prior to arrest and circumstances at the time of arrest, the following appeared as independent predictors of hospital mortality: (1) interval between collapse and first defibrillation ( P < 0.001); (2) on chronic medication with diuretics ( P < 0.01); (3) age ( P < 0.01); (4) bystander initiated CPR ( P < 0.05); and (5) a history of diabetes ( P < 0.05). In a multivariate analysis considering various aspects of status on admission to hospital, the following were independently associated with death: (1) degree of consciousness ( P < 0.001) and (2) systolic blood pressure ( P < 0.05). In conclusion, among patients with out of hospital cardiac arrest found in ventricular fibrillation and being hospitalised alive, 54% died in hospital. The in-hospital mortality was related to patient characteristics before the cardiac arrest as well as to factors at the resuscitation itself.