Outcome predictors of patients with out of hospital cardiac arrest and immediate coronary angiography

Abstract

Background: Out of hospital cardiac arrest (OHCA) is common and associated with low survival rates. Guidelines propose a fast work-up after OHCA including coronary angiography (CA) but little is known about the actual outcome of those patients who undergo immediate CA after OHCA with suspected cardiac origin. Aim: The aim of this retrospective single-center study was to evaluate the short-term outcomes and predictors of in-hospital mortality in patients who underwent immediate CA after OHCA with suspected cardiac origin. Methods: We included all consecutive patients with OHCA who underwent immediate CA between January 2011 and December 2015. We defined immediate CA after OHCA as angiography within 2 hr after admission. Results: Two hundred and nineteen consecutive patients with OHCA were included. Fifty six patients (26%) underwent CA without previous return of spontaneous circulation (ROSC) and with ongoing CPR using the LUCAS-device. One hundred and forty nine patients (67%) died in hospital. Of the 56 patients with CA with ongoing CPR, 55 died and only 1 patient survived to hospital discharge. In a multivariate analysis, older age (OR = 2.03, 95%CI 1.35–3.03; p =.001), initial shockable rhythm (OR = 0.28, 95%CI 0.07–1.13; p =.076), CA with ongoing CPR (OR = 11.63, 95%CI 1.20–122.55; p =.035), and initial arterial pH (OR = 0.008, 95%CI 0.00–0.228; p