Independent Predictors of 6-Month Mortality in Patients Successfully Resuscitated for Out-of-Hospital Cardiac Arrest: Observational Retrospective Single Center Study

Abstract

Background. Mortality of admitted out-of-hospital cardiac arrest (OHCA) patients is decreasing. Our aim was to evaluate independent predictors of six-month mortality of successfully resuscitated OHCA patients. Methods. We reviewed retrospectively the records of 119 OHCA patients, admitted in 2011 to 2013 (73.1% men, mean age 64 ± 13,5 years) and registered their clinical data, treatments, and predictors of 6-month mortality. Results. Six-month mortality of admitted OHCA patients was 47.5% and was associated significantly with older age (67.7 ± 12.9 years versus 59.9 ± 13 years, p<0.05), mechanical ventilation, longer time of resuscitation (24.6 ± 18.9 sec versus 8.9 ± 8.4 sec, p<0.05), use of vasopressors (87.3% versus 62.5%, p<0.05), and increased serum lactate (8.1 ± 3.9 mmol/l versus 4.5 ± 3.6 mmol/l, p<0.05) but less likely with prior shockable rhythm (38% versus 73.2%, p<0.05), percutaneous coronary intervention (27% versus 55.4%, p<0.05), achieved target temperatures 32°-34°C of mild therapeutic hypothermia (47.6% versus 71.4%, p<0.05), acute coronary syndromes (31.7% versus 51.8%, p<0.05), and neurological recovery (4.8% versus 69.6%, p<0.05) when compared to survivors. Neurological outcome was most significant early independent predictor of 6-month mortality (OR 50.47; 95% CI 6.74 to 377.68; p<0.001). Conclusions. Postcardiac arrest brain injury most significantly and independently predicted 6-month mortality in hospitalized OHCA patients.