Prognosis of patients admitted to the coronary or intensive care unit after an out of hospital episode of sudden death

Introduction and objective. Out of hospital sudden death constitutes a majo r sanitary problem. Early diagnosis and treatment are considered as the mos t important factors related with short term prognosis. However, there is li ttle information about the outcome of patients admitted to the hospital aft er a successful recovery from an episode of sudden death outside the hospit al. The objective of this study was to analyze the prognosis of patients wh o initially recovered after an episode of out-of-hospital cardiac arrest an d who were admitted to the coronary or intensive care unit. Patients and methods. The clinical characteristics and outcome of 110 conse cutive patients admitted to the coronary and intensive care units after an episode of extrahospital sudden death, who initially recovered with success , were retrospectively studied. Results. A total of 33 (30%) patients were discharged alive and without sev ere neurological damage, 67 (61%) patients died before discharge from hospi tal and 77 (70%) died or presented severe and permanent neurological damage . The latter group versus those who survived was older (63.6 +/- 13.5 vs 55 .2 +/- 12.6 years old; p < 0.006) and had a longer delay in the begining of cardiopulmonary resuscitation (8.3 vs 2.8 min.; p < 0.01). Mortality or se vere neurological damage rate was higher in the group of those who had asys tolia than in those with ventricular fibrilation in the first ECG (84% vs 5 5%), in those who arrived to the hospital unconcious (73.7% vs 15.4%) and i n those who arrived in functional class IV (81% vs 16.6%). Conclusions. Up to 30% of the patients admitted after an episode of extraho spital cardiac arrest were dicharged alive and without severe neurological damage. Advanced age, functional class IV and the delay of cardiopulmonary resuscitation are related to a unfavorable outcome.