Is hospital care of major importance for outcome after out-of-hospital cardiac arrest? Experience acquired from patients with out-of-hospital cardiacarrest resuscitated by the same Emergency Medical Service and admitted to one of two hospitals over a 16-year period in the municipality of Goteborg
J. Engdahl et al., Is hospital care of major importance for outcome after out-of-hospital cardiac arrest? Experience acquired from patients with out-of-hospital cardiacarrest resuscitated by the same Emergency Medical Service and admitted to one of two hospitals over a 16-year period in the municipality of Goteborg, RESUSCITAT, 43(3), 2000, pp. 201-211
Aim: To describe patient characteristics, hospital investigations and inter
ventions and early mortality among patients being hospitalized after out-of
-hospital cardiac arrest in two hospitals. Setting: Municipality of Gotebor
g, Sweden. Patients: All patients suffering an out-of-hospital cardiac arre
st who were successfully resuscitated and admitted to hospital between 1 Oc
tober 1980 and 31 December 1996. All patients were resuscitated by the same
Emergency Medical Service and admitted alive to one of the two city hospit
als in Goteborg. Results: Of 579 patients admitted to Sahlgrenska Hospital,
253 (44%) were discharged alive and of 459 patients admitted to Ostra Hosp
ital, 152 (33%) were discharged alive (P < 0.001). More patients in Sahlgre
nska Hospital were still receiving cardiopulmonary resuscitation (CPR) trea
tment (P = 0.03), but patients in Ostra had a lower systolic blood pressure
and higher heart rate on admission. A larger percentage of patients admitt
ed to Sahlgrenska Hospital underwent coronary angiography (P<0.001), electr
ophysiological testing (P<0.001), Holter recording (P<0.001), echocardiogra
phy (P=0.004), Percutaneous Transluminal Coronary Angioplasty (PTCA, P=0.00
9), implantation of Automatic Implantable Cardioverter Defibrillator (AICD,
P = 0.03) and exercise stress tests (P = 0.003). Inhabitants in the catchm
ent area of Ostra hospital had a less favourable socio-economic profile. Co
nclusion: Survival after out-of-hospital cardiac arrest may be affected by
the course of hospital management. Other variables that might influence sur
vival are socio-economic factors and cardiorespiratory status on admission
to hospital. Further investigation is called for as more patients are being
hospitalised alive after out-of-hospital cardiac arrest. (C) 2000 Elsevier
Science Ireland Ltd. All rights reserved.