LONG-TERM FOLLOW-UP AFTER OUT-OF-HOSPITAL CARDIAC-ARREST

Survival rate after out-of-hospital cardiac arrest varies according to evaluation criteria. It can be estimated that in 22 to 63% of the cas es, effective hemodynamic performance is restored although hospital mo rtality is much higher, reaching 63%. Death, frequent after prolonged cardiac arrest, is usually due to recurrent cardiac arrest or the effe cts of prolonged anoxia. Mortality in patients who survive the hospita lization period is approximately 20% during the year following dischar ge. Consequently one year after out-of-hospital cardiac arrest, only 5 % of the patients are still alive. The quality of life varies greatly in these survivors; the course of neurological sequellae may be favora ble in approximately half but leads to death in others. The primary fa ctor predicting survival is the underlying pathology, highly influence d by age. Inversely, factors predicting a more favorable outcome inclu de ventricular tachycardia as the origin of cardiac arrest, presence o f other people at onset and rapid recovery of spontaneous hemodynamic activity. Loss of consciousness for more than 24 hours, defective bulb ar reflexes and anomalies on the electroencephalogram are signs of gra vity as are high blood glucose, major brain edema and abolition of som esthesic and auditive evoked potentials.