REHOSPITALIZATION IN SURVIVING PATIENTS OF OUT-OF-HOSPITAL VENTRICULAR-FIBRILLATION (THE CASCADE STUDY)

Surviving patients of out-of-hospital ventricular fibrillation (VF) of ten need rehospitalization after initial hospital discharge, but littl e is known regarding the frequency of or reasons for rehospitalization . Rehospitalization was examined in 224 patients enrolled in the Cardi ac Arrest in Seattle: Conventional Amiodarone Drug Evaluation (CASCADE ) study, a randomized clinical trial comparing amiodarone with other a ntiarrhythmic drug therapy in survivors of out-of-hospital VF. The ann ual rate of rehospitalization was 79/100 patients/year; 168 of 224 pat ients (75%) were hospitalized at least once before censoring or cardia c mortality. Baseline left ventricular ejection fraction was significa ntly lower in patients who were rehospitalized. Rehospitalization rate s were lower in patients randomized to amiodarone therapy and in those with the automatic implantable cardioverter-defibrillator, although n either difference was statistically significant. However, length of st ay for the first rehospitalization was shorter for patients with autom atic implantable cardioverter-defibrillators (p = 0.005). More than 50 % of patients were rehospitalized in the first year after enrollment; 65% with ejection fractions less-than-or-equal-to 0.3 were rehospitali zed in the first year. Rehospitalization was a frequent occurrence for surviving patients of out-of-hospital VF, particularly in those with low ejection fractions.