HOSPITAL MORTALITY AFTER OUT-OF-HOSPITAL CARDIAC-ARREST AMONG PATIENTS FOUND IN VENTRICULAR-FIBRILLATION

The aim of this study was to describe factors associated with in-hospi tal mortality among patients being hospitalised after out-of-hospital cardiac arrest and who were found in ventricular fibrillation. The stu dy was set in the community of Goteborg, Sweden. The subjects consiste d of ah patients who were hospitalised alive-after out-of-hospital car diac arrest, being reached by our mobile coronary care unit and who we re found in ventricular fibrillation, between 1981 and 1992. In all, 4 88 patients fullfilled the inclusion criteria of which 262 (54%) died during initial hospitalization. In a multivariate analysis including a ge, sex; history of cardiovascular disease, chronic medication prior t o arrest and circumstances at the time of arrest, the following appear ed as independent predictors of hospital mortality: (1) interval betwe en collapse and first defibrillation (P < 0.001); (2) on chronic medic ation with diuretics (P < 0.01); (3)age (P < 0.01); (4) bystander init iated CPR (P < 0.05); and (5) a history of diabetes (P < 0.05). In a m ultivariate analysis considering various aspects of status on admissio n to hospital, the following were independently associated with death: (1) degree of consciousness (P < 0.001) and (2) systolic blood pressu re (P < 0.05). In conclusion, among patients with out of hospital card iac arrest found in ventricular fibrillation and being hospitalised al ive, 54% died in hospital. The in-hospital mortality was related to pa tient characteristics before the cardiac arrest as well as to factors at the resuscitation itself.