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Survival rate of incoming patients with cardiac arrest at the cardiology infirmary of the emergency department of a public hospital in Greece


Styliani Papadopoulou
Olympia Konstantakopoulou
Antonia Kalogianni
Martha Kelesi-Stavropoulou
Theodore Kapadohos
Abstract

Introduction: Cardiac arrest is an urgent situation that, despite the improved resuscitation capabilities, the survival rate of out-of-hospital cardiac arrest victims remains low.

Aim: Τo investigate the survival rate of the incoming patients with cardiac arrest in the cardiology infirmary of the emergency department of a public hospital.

Material-Method: The study included 210 patients who were transferred pulseless and breathless at the cardiology infirmary of the emergency department of “Tzaneio” Hospital, Piraeus, during the period April 2017 - November 2018. Data was collected from the National Center of Emergency Dispatch's printed forms, as well as from the patients’ admission book of the emergency department.

Results: More than 10% (11.9%) of patients with cardiac arrest returned to spontaneous circulation in the emergency department, of which 16% was discharged. Patients with known cardiac history, (p=0.002), with a shockable rhythm (p<0.001), and especially ventricular fibrillation (p<0.001) upon arrival at the emergency room, and patients who were defibrillated at the ambulance during admission and at the emergency room, were more likely to survive (p<0.001). No statistically significant correlation was found between the factors studied and survival after cardiac arrest, in the group of patients that were discharged.

Conclusions: The survival rate of the incoming patients with cardiac arrest at the emergency department of “Tzaneio” Hospital, Piraeus, was low. As for most health systems, this issue constitutes a fairly complex public health problem. Cardiopulmonary resuscitation and corresponding guidelines require further improvement in order for the survival rates of out-of-hospital cardiac arrest patients to increase.

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References
Kapadohos T. Cardiac Arrest. In: Marvaki Ch, Kotanidou A, Papageorgiou D, Kalogianni A (authors). Emergency Nursing (Book written in Greek). Athens: Konstantaras Medical Books; 2015. Pages 131-49.
McCoy MA, Schultz AM. Exploring Strategies to improve cardiac arrest survival. United States of America: The Ntional Academies of press; 2017.
Ewy GA. The cardiocerebral resuscitation protocol for treatment of out-of-hospital primary cardiac arrest. Scand J Trauma Resusc Emerg Med. 2012;20:65.
Ogawa Y, Shiozaki T, Hirose T, Ohnishi M, Nakamori Y, Ogura H, et al. Load-distributing-band cardiopulmonary resuscitation for out-of-hospital cardiac arrest increases regional cerebral oxygenation: a single-center prospective pilot study. Scand J Trauma Resusc Emerg Med. 2015;23:99.
Mangla A, Daya MR, Gupta S. Post-resuscitation care for survivors of cardiac arrest. Indian Heart J. 2014;66 Suppl 1:S105-12.
van de Glind EM, van Munster BC, van de Wetering FT, van Delden JJ, Scholten RJ, Hooft L. Pre-arrest predictors of survival after resuscitation from out-of-hospital cardiac arrest in the elderly a systematic review. BMC Geriatr. 2013;13:68.
Youness H, Al Halabi T, Hussein H, Awab A, Jones K, Keddissi J. Review and Outcome of Prolonged Cardiopulmonary Resuscitation. Crit Care Res Pract. 2016;2016:7384649.
Jeong S, Ahn KO, Shin SD. The role of prehospital advanced airway management on outcomes for out-of-hospital cardiac arrest patients: a meta-analysis. Am J Emerg Med. 2016;34(11):2101-6.
Ha TS, Yang JH, Cho YH, Chung CR, Park CM, Jeon K, et al. Clinical outcomes after rescue extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest. Emerg Med J. 2017;34(2):107-11.
Fouche PF, Jennings PA. Physician presence at out-of-hospital cardiac arrest is not necessarily the cause of improved survival. Scand J Trauma Resusc Emerg Med. 2016;24(1):88.
Sugiyama A, Duval S, Nakamura Y, Yoshihara K, Yannopoulos D. Impedance Threshold Device Combined With High-Quality Cardiopulmonary Resuscitation Improves Survival With Favorable Neurological Function After Witnessed Out-of-Hospital Cardiac Arrest. Circ J. 2016;80(10):2124-32.
Girotra S, van Diepen S, Nallamothu BK, Carrel M, Vellano K, Anderson ML, et al. Regional Variation in Out-of-Hospital Cardiac Arrest Survival in the United States. Circulation. 2016;133(22):2159-68.
Benson-Cooper KA. Therapeutic hypothermia is independently associated with favourable outcome after resuscitation from out-of-hospital cardiac arrest: a retrospective, observational cohort study. N Z Med J. 2015;128(1427):33-7.
Ageron FX, Debaty G, Gayet-Ageron A, Belle L, Gaillard A, Monnet MF, et al. Impact of an emergency medical dispatch system on survival from out-of-hospital cardiac arrest: a population-based study. Scand J Trauma Resusc Emerg Med. 2016;24:53.
Funada A, Goto Y, Maeda T, Teramoto R, Hayashi K, Yamagishi M. Improved Survival With Favorable Neurological Outcome in Elderly Individuals With Out-of-Hospital Cardiac Arrest in Japan- A Nationwide Observational Cohort Study. Circ J. 2016;80(5):1153-62.
Hasselqvist-Ax I, Riva G, Herlitz J, Rosenqvist M, Hollenberg J, Nordberg P, et al. Early cardiopulmonary resuscitation in out-of-hospital cardiac arrest. N Engl J Med. 2015;372(24):2307-15.
Oman G, Bury G. Use of telephone CPR advice in Ireland: Uptake by callers and delays in the assessment process. Resuscitation. 2016;102:6-10.
Capucci A, Aschieri D, Guerra F, Pelizzoni V, Nani S, Villani GQ, et al. Community-based automated external defibrillator only resuscitation for out-of-hospital cardiac arrest patients. Am Heart J. 2016;172:192-200.
Kitamura T, Kiyohara K, Matsuyama T, Izawa J, Shimamoto T, Hatakeyama T, et al. Epidemiology of Out-of-Hospital Cardiac Arrests Among Japanese Centenarians: 2005 to 2013. Am J Cardiol. 2016;117(6):894-900.
Kuo CW, See LC, Tu HT, Chen JC. Adult out-of-hospital cardiac arrest based on chain of survival in Taoyuan County, northern Taiwan. J Emerg Med. 2014;46(6):782-90.
Galatianou I, Karlis G, Apostolopoulos A, Intas G, Chalari E, Gulati A, et al. Body mass index and outcome of out-of-hospital cardiac arrest patients not treated by targeted temperature management. Am J Emerg Med. 2017;35(9):1247-51.
Karagiannis C, Georgiou M, Kouskouni E, Iacovidou N, Xanthos T. Association of lactate levels with outcome after in-hospital cardiac arrest. Resuscitation. 2012;83(8):e175-6.
El Sayed MJ, Tamim H, Nasreddine Z, Dishjekenian M, Kazzi AA. Out-of-hospital cardiac arrest survival in Beirut, Lebanon. Eur J Emerg Med. 2014;21(4):281-3.
Fan KL, Leung LP, Siu YC. Out-of-hospital cardiac arrest in Hong Kong: a territory-wide study. Hong Kong Med J. 2017;23(1):48-53.
Boyce LW, Vliet Vlieland TP, Bosch J, Wolterbeek R, Volker G, van Exel HJ, et al. High survival rate of 43% in out-of-hospital cardiac arrest patients in an optimised chain of survival. Neth Heart J. 2015;23(1):20-5.
Lee MH, Fook-Chong S, Wah W, Shin SD, Nishiuchi T, Ko PC, et al. Effect of known history of heart disease on survival outcomes after out-of-hospital cardiac arrests. Emerg Med Australas. 2018;30(1):67-76.
Blom MT, Beesems SG, Homma PC, Zijlstra JA, Hulleman M, van Hoeijen DA, et al. Improved survival after out-of-hospital cardiac arrest and use of automated external defibrillators. Circulation. 2014;130(21):1868-75.
Stromsoe A, Svensson L, Axelsson AB, Claesson A, Goransson KE, Nordberg P, et al. Improved outcome in Sweden after out-of-hospital cardiac arrest and possible association with improvements in every link in the chain of survival. Eur Heart J. 2015;36(14):863-71.
Bhandari S, Doan J, Blackwood J, Coult J, Kudenchuk P, Sherman L, et al. Rhythm profiles and survival after out-of-hospital ventricular fibrillation cardiac arrest. Resuscitation. 2018;125:22-7.
Hasegawa M, Abe T, Nagata T, Onozuka D, Hagihara A. The number of prehospital defibrillation shocks and 1-month survival in patients with out-of-hospital cardiac arrest. Scand J Trauma Resusc Emerg Med. 2015;23:34.
Garcia EL, Caffrey-Villari S, Ramirez D, Caron JL, Mannhart P, Reuter PG, et al. [Impact of onsite or dispatched automated external defibrillator use on early survival after sudden cardiac arrest occurring in international airports]. Presse Med. 2017;46(3):e63-e8.
Link MS, Berkow LC, Kudenchuk PJ, Halperin HR, Hess EP, Moitra VK, et al. Part 7: Adult Advanced Cardiovascular Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132(18 Suppl 2):S444-64.
Pan J, Zhu JY, Kee HS, Zhang Q, Lu YQ. A review of compression, ventilation, defibrillation, drug treatment, and targeted temperature management in cardiopulmonary resuscitation. Chin Med J (Engl). 2015;128(4):550-4.
Podrid J, Ganz I. Pathogenesis of ventricular tachycardia and ventricular fibrillation during acute myocardial infarction. UpToDate. Waltham, MA: UpToDate; [Από: https://www.uptodate.com/contents/pathogenesis-of-ventricular-tachycardia-and-ventricular-fibrillation-during-acute-myocardial-infarction
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