1Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Korea
2Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Korea
Copyright © 2016 The Korean Society of Critical Care Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Values are presented as mean ± SD or n (%).
SD: standard deviation; PEA: pulseless electrical activity; VF: ventricular fibrillation; VT: ventricular tachycardia; BLS: basic life support; ACLS: advanced cardiac life support; ROSC: return of spontaneous circulation; APACHE: acute physiology and chronic health evaluation; CPR: cardiopulmonary resuscitation; CAD: coronary artery disease; CVA: cerebro-vascular accident; COPD: chronic obstructive pulmonary disease; CRF: chronic renal failure; PCI: percutaneous coronary intervention; TTE: transthoracic echocardiography; LVEDD: left ventricular end-diastolic diameter; LVESD: left ventricular end-systolic diameter; LV: left ventricle.
Values are presented as mean ± SD or %.
PEA: pulseless electrical activity; VF: ventricular fibrillation; VT: ventricular tachycardia; BLS: basic life support; ACLS: advanced cardiac life support; ROSC: return of spontaneous circulation; APACHE: acute physiology and chronic health evaluation; CAD: coronary artery disease; CVA: cerebro-vascular accident; COPD: chronic obstructive pulmonary disease; CRF: chronic renal failure; PCI: percutaneous coronary intervention TTE: transthoracic echocardiography; LVEDD: left ventricular enddiastolic diameter; LVESD: left ventricular end-systolic diameter; LV: left ventricle; SD: standard deviation.
Variable | Value |
---|---|
Age (years) | 54.4 ± 15.3 |
Sex | |
Female | 29 (27.9) |
Male | 75 (72.1) |
Rhythm, initial | |
Asystole | 39 (37.9) |
PEA | 23 (23.3) |
VF/VT | 41 (39.8) |
Time to BLS (min) | 8.7 ± 8.8 |
Time to ACLS (min) | 24.0 ± 12.4 |
Time to ROSC (min) | 28.0 ± 16.1 |
Arrest by | |
Cardiac origin | 55 (52.9) |
Non-cardiac | 49 (47.1) |
APACHE II | 26.1 ± 6.0 |
Lactate level just after CPR | 8.4 ± 3.6 |
Co-morbidity | |
Hypertension | 36 (34.6) |
Diabetes | 20 (19.2) |
Heart failure | 4 (3.9) |
CAD | 10 (9.6) |
Arrhythmia | 8 (7.7) |
CVA | 3 (2.9) |
COPD/Asthma | 3 (2.9) |
CRF | 7 (6.7) |
Performed a PCI | 20 (19.2) |
TTE findings | |
LVEDD (n = 103) (mm) | 46.4 ± 8.2 |
< 42 | 22 (21.2) |
42-54 | 68 (65.4) |
> 54 | 14 (13.5) |
LVESD (n = 103) (mm) | 34.3 ± 9.5 |
< 24 | 10 (9.6) |
24-36 | 58 (55.8) |
> 36 | 36 (34.6) |
LV ejection fraction (%) | 49.5 ± 17.5 |
< 45 | 39 (37.5) |
45-55 | 18 (17.3) |
> 55 | 47 (45.2) |
6-month neurologic outcome |
3-month mortality |
7-day mortality |
|||||||
---|---|---|---|---|---|---|---|---|---|
Survived | Dead | p-value | Survived | Dead | p-value | Survived | Dead | p-value | |
Number | 36 | 68 | 62 | 42 | 79 | 25 | |||
Age (years) | 52.1 ± 14.7 | 55.6 ± 15.5 | 0.267 | 53.6 ± 15.1 | 55.5 ± 15.6 | 0.530 | 53.0 ± 15.3 | 58.6 ± 14.7 | 0.109 |
Female | 19.4 | 32.4 | 0.163 | 24.2 | 33.3 | 0.308 | 22.8 | 44.0 | 0.039 |
Hypothermia treatment | 88.9 | 91.2 | 0.707 | 91.9 | 88.1 | 0.515 | 91.1 | 88.0 | 0.643 |
Initial rhythm (n = 103) | |||||||||
Asystole | 17.1 | 48.5 | < 0.001 | 24.6 | 57.1 | 0.004 | 32.1 | 56.0 | 0.049 |
PEA | 17.1 | 25.0 | 27.9 | 14.3 | 26.9 | 8.0 | |||
VF/VT | 65.7 | 26.5 | 47.5 | 28.6 | 41.0 | 36.0 | |||
Time to BLS (min) (n = 100) | 8.4 ± 6.7 | 8.9 ± 9.8 | 0.766 | 7.2 ± 6.8 | 11.0 ± 10.9 | 0.034 | 8.2 ± 7.4 | 10.5 ± 12.2 | 0.260 |
Time to ACLS (min) (n = 102) | 21.7 ± 10.1 | 25.1 ± 13.3 | 0.190 | 21.4 ± 10.5 | 27.7 ± 14.0 | 0.010 | 23.1 ± 11.3 | 26.6 ± 15.3 | 0.229 |
Time to ROSC (min) | 19.3 ± 11.5 | 32.6 ± 16.3 | < 0.001 | 23.0 ± 14.5 | 35.5 ± 15.5 | < 0.001 | 25.4 ± 15.1 | 36.2 ± 16.5 | 0.003 |
Arrest cause | |||||||||
Cardiac | 83.3 | 36.8 | < 0.001 | 61.3 | 40.5 | 0.095 | 54.3 | 48.0 | 0.771 |
Non-cardiac | 16.7 | 63.2 | 38.7 | 59.5 | 45.7 | 52.0 | |||
APACHE II | 23.9 ± 5.1 | 27.3 ± 6.2 | 0.005 | 25.5 ± 5.6 | 27.0 ± 6.6 | 0.209 | 25.3 ± 5.7 | 28.6 ± 6.3 | 0.015 |
Lactate level | 7.3 ± 3.3 | 9.0 ± 3.7 | 0.021 | 8.0 ± 3.6 | 9.0 ± 3.6 | 0.138 | 7.9 ± 3.7 | 9.8 ± 3.1 | 0.021 |
Underlying disease | |||||||||
Hypertension | 30.6 | 36.8 | 0.527 | 37.1 | 31.0 | 0.518 | 32.9 | 40.0 | 0.516 |
Diabetes | 8.3 | 25.0 | 0.040 | 21.0 | 16.7 | 0.585 | 17.7 | 24.0 | 0.488 |
Heart failure | 5.6 | 2.9 | 0.510 | 4.8 | 2.4 | 0.522 | 5.1 | 0 | 0.251 |
CAD | 8.3 | 10.3 | 0.747 | 8.1 | 11.9 | 0.515 | 10.1 | 8.0 | 0.753 |
Arrhythmia | 8.3 | 7.4 | 0.858 | 9.7 | 4.8 | 0.356 | 8.0 | 8.0 | 0.947 |
CVA | 0 | 4.4 | 0.201 | 1.6 | 4.8 | 0.346 | 1.3 | 8.0 | 0.080 |
COPD/Asthma | 0 | 4.4 | 0.201 | 1.6 | 4.8 | 0.346 | 2.5 | 4.0 | 0.702 |
CRF | 0 | 10.3 | 0.046 | 6.5 | 7.1 | 0.890 | 8.0 | 4.0 | 0.532 |
Performed a PCI | 30.6 | 13.2 | 0.033 | 24.2 | 11.9 | 0.119 | 22.8 | 8.0 | 0.102 |
TTE findings | |||||||||
Abnormal LVEDD (mm) | 33.3 | 35.3 | 0.842 | 32.3 | 38.1 | 0.539 | 32.9 | 40.0 | 0.516 |
Abnormal LVESD (mm) | 47.2 | 42.7 | 0.655 | 41.9 | 47.6 | 0.567 | 40.5 | 56.0 | 0.174 |
Moderate and Severe LV dysfunction | 36.1 | 38.2 | 0.831 | 32.3 | 45.2 | 0.180 | 31.7 | 56.0 | 0.028 |
Univariate |
Multivariate |
|||
---|---|---|---|---|
OR (95% CI) | p-value | OR (95% CI) | p-value | |
Asystole/PEA (vs. VF/VT) | 2.75 (1.09-6.91) | 0.031 | ||
Long time to ROSC (per 1 min) | 1.04 (1.01-1.07) | 0.007 | 1.04 (1.00-1.07) | 0.034 |
High APACHE II (per 1) | 1.10 (1.02-1.18) | 0.018 | 1.10 (1.01-1.20) | 0.042 |
High lactate level (per 1 mmol/L) | 1.17 (1.02-1.34) | 0.025 | ||
Moderate and Severe LV dysfunction (EF < 45%) | 2.75 (1.09-6.91) | 0.031 | 3.02 (1.01-9.01) | 0.047 |
Values are presented as mean ± SD or n (%). SD: standard deviation; PEA: pulseless electrical activity; VF: ventricular fibrillation; VT: ventricular tachycardia; BLS: basic life support; ACLS: advanced cardiac life support; ROSC: return of spontaneous circulation; APACHE: acute physiology and chronic health evaluation; CPR: cardiopulmonary resuscitation; CAD: coronary artery disease; CVA: cerebro-vascular accident; COPD: chronic obstructive pulmonary disease; CRF: chronic renal failure; PCI: percutaneous coronary intervention; TTE: transthoracic echocardiography; LVEDD: left ventricular end-diastolic diameter; LVESD: left ventricular end-systolic diameter; LV: left ventricle.
Values are presented as mean ± SD or %. PEA: pulseless electrical activity; VF: ventricular fibrillation; VT: ventricular tachycardia; BLS: basic life support; ACLS: advanced cardiac life support; ROSC: return of spontaneous circulation; APACHE: acute physiology and chronic health evaluation; CAD: coronary artery disease; CVA: cerebro-vascular accident; COPD: chronic obstructive pulmonary disease; CRF: chronic renal failure; PCI: percutaneous coronary intervention TTE: transthoracic echocardiography; LVEDD: left ventricular enddiastolic diameter; LVESD: left ventricular end-systolic diameter; LV: left ventricle; SD: standard deviation.
OR: odds ratio; CI: confidence interval; PEA: pulseless electrical activity; VF: ventricular fibrillation; VT: ventricular tachycardia; ROSC: return of spontaneous circulation; APACHE: acute physiology and chronic health evaluation; LV: left ventricle; EF: ejection fraction.