AUTHOR=Baldi Enrico , Compagnoni Sara , Buratti Stefano , Primi Roberto , Bendotti Sara , Currao Alessia , Gentile Francesca Romana , Sechi Giuseppe Maria , Mare Claudio , Bertona Roberta , Raimondi Cominesi Irene , Taravelli Erika , Fava Cristian , Danzi Gian Battista , Oltrona Visconti Luigi , Savastano Simone , all the Lombardia CARe Researchers , Villa Guido Francesco , Matiz Guido , Migliori Maurizio , Pagliosa Andrea , Canevari Fabrizio , Brancaglione Antonella , Palo Alessandra , Contri Enrico , Ronchi Vincenza , De Pirro Antonella , Molinari Simone , Sgromo Vito , Paglino Martina , Mojoli Francesco , Curti Moreno , Klersy Catherine , Musella Valeria , Carnevale Livio , Marioni Arianna , Bergamini Giuseppe , Reali Francesca , Rizzi Ugo , Bussi Daniele , Ruggeri Simone , Moschini Luigi , Zanotti Laura , Storti Enrico , Parogni Pierpaolo , Facchin Fabio , Buetto Giovanni , Luppi Mario , Franchi Dario , Caresani Matteo , Campi Sabina , Centineo Paola , De Ponti Roberto , Russo Alessandra , Vecchi Andrea Lorenzo , Fantoni Cecilia , Franzosi Cinzia , Vimercati Claudio , Giovenzana Fulvio , Caico Salvatore Ivan , Genoni Paola , Castiglioni Battistina , Botteri Marco , Perone Giovanna , Panni Gianluca , Bettari Luca , Ghiraldin Daniele , Maffeo Diego , Paiella Marco , Piccolo Umberto , Cazzaniga Marco , Passarelli Ilaria
TITLE=Long-Term Outcome After Out-of-Hospital Cardiac Arrest: An Utstein-Based Analysis
JOURNAL=Frontiers in Cardiovascular Medicine
VOLUME=8
YEAR=2021
URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.764043
DOI=10.3389/fcvm.2021.764043
ISSN=2297-055X
ABSTRACT=Background: No data are available regarding long-term survival of out-of-hospital cardiac arrest (OHCA) patients based on different Utstein subgroups, which are expected to significantly differ in terms of survival. We aimed to provide the first long-term survival analysis of OHCA patients divided according to Utstein categories.
Methods: We analyzed all the 4,924 OHCA cases prospectively enrolled in the Lombardia Cardiac Arrest Registry (Lombardia CARe) from 2015 to 2019. Pre-hospital data, survival, and cerebral performance category score (CPC) at 1, 6, and 12 months and then every year up to 5 years after the event were analyzed for each patient.
Results: A decrease in survival was observed during the follow-up in all the Utstein categories. The risk of death of the “all-EMS treated” group exceeded the general population for all the years of follow-up with standardized mortality ratios (SMRs) of 23 (95%CI, 16.8–30.2), 6.8 (95%CI, 3.8–10.7), 3.8 (95%CI, 1.7–6.7), 4.05 (95%CI, 1.9–6.9), and 2.6 (95%CI, 1.03–4.8) from the first to the fifth year of follow-up. The risk of death was higher also for the Utstein categories “shockable bystander witnessed” and “shockable bystander CPR”: SMRs of 19.4 (95%CI, 11.3–29.8) and 19.4 (95%CI, 10.8–30.6) for the first year and of 6.8 (95%CI, 6.6–13) and 8.1 (95%CI, 3.1–15.3) for the second one, respectively. Similar results were observed considering the patients discharged with a CPC of 1–2.
Conclusions: The mortality of OHCA patients discharged alive from the hospital is higher than the Italian standard population, also considering those with the most favorable OHCA characteristics and those discharged with good neurological outcome. Long-term follow-up should be included in the next Utstein-style revision.