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Two-year survival and neurological outcome of in-hospital cardiac arrest patients rescued by extracorporeal cardiopulmonary resuscitation

2013; Elsevier BV; Volume: 168; Issue: 4 Linguagem: Inglês

10.1016/j.ijcard.2013.04.183

1874-1754

Tae Gun Shin, Ik Joon Jo, Min Seob Sim, Yong-Bien Song, Jung-Hoon Yang, Joo‐Yong Hahn, Seung‐Hyuk Choi, Hyeon‐Cheol Gwon, Eun‐Seok Jeon, Kiick Sung, Young Tak Lee, Jin‐Ho Choi,

Cardiac Structural Anomalies and Repair

Abstract Background The clinical benefit of extracorporeal cardiopulmonary resuscitation (E-CPR) has been proved in short-term follow-up studies. However, the benefit of E-CPR beyond 1year has been not known. We investigated 2-year outcome of patients who received E-CPR or conventional CPR (C-CPR). Methods We analyzed a total of 406 adult in-hospital cardiac arrest victims who underwent CPR for more than 10min from 2003 to 2009. The two-year survival and neurological outcome of E-CPR ( n =85) and C-CPR ( n =321) were compared using propensity score-matched analysis. Results The 2-year survival with minimal neurological impairment was 4-fold higher in the E-CPR group than the C-CPR group (23.5% versus 5.9%, hazard ratio (HR)=0.57, 95% confidence interval (CI)=0.43–0.75, p <0.001) by unadjusted analysis. After propensity-score matching, it was still 4-fold higher in the E-CPR group than the C-CPR group (20.0% versus 5.0%, HR=0.53, 95% CI=0.36–0.80, p =0.002). In the E-CPR group, the independent predictors associated with minimal neurological impairment were age ≤65years (HR=0.46; 95% CI=0.26–0.81; p =0.008), CPR duration ≤35min (HR=0.37; 95% CI=0.18–0.76; p =0.007), and subsequent cardiovascular intervention including coronary intervention or cardiac surgery (HR=0.36; 95% CI=0.18–0.68; p =0.002). Conclusions The initial survival benefit of E-CPR for cardiac arrest patients persisted at 2years.