Outcomes after Clinical and Traumatic Out-of-Hospital Cardiac Arrest

To describe the out-of-hospital/in-hospital survival, survival time, and neurological conditions of those treated by advanced life support units and submitted to cardiopulmonary resuscitation and compare the results of clinical and traumatic cardiac arrests.

Methods

This is a cohort study carried out in three stages; in the first two, data were collected from the Mobile Emergency Care Service forms and medical records; then, the Brain Performance Category Scale was applied in the third stage. The sample consisted of resuscitated victims aged ≥18 years. Fisher’s and log-rank tests were used to compare the causes, considering a significance level of 5%.

Results

852 patients were analyzed; 20.66% were hospitalized, 4.23% survived until transfer or discharge, and 58.33% had a favorable outcome one year after arrest. There was an association between pre/in-hospital survival and the nature of the occurrence (p=0.026), but there was no difference between the survival curves (p=0.6).

Conclusions

Survival of hospitalization after out-of-hospital cardiac arrest was low; however, most who survived to be discharged achieved a favorable outcome after one year. The survival time of those hospitalized after clinical and traumatic events were similar, but pre-hospital survival was higher among trauma patients.

Heart Arrest; Out-of-Hospital Cardiac Arrest; Cardiopulmonary Resuscitation; Emergency Medical Services; Survivorship

Variables	No.	%
Gender
Male	556	65.26
Female	296	34.74
Age range (years)
≥18 <35	56	6.57
≥35 <50	105	12.32
≥50 <65	225	26.41
≥65 <80	312	36.62
≥ 80	154	18.08
Comorbidities and at-risk habits
Yes	600	70.42
No	252	29.58

Comorbidities and at-risk habits	No.	%
Arterial hypertension	377	44.25
Cardiopathies	221	25.94
Diabetes	205	24.06
Neuropathies	104	12.21
Pneumopathies	57	6.69
Alcoholism	45	5.28
Smoking	42	4.93
Cancer	38	4.46
Nephropathies	34	3.99
Psychiatric illnesses	18	2.11
Obesity	16	1.88
Vascular diseases	8	0.94
Hepatopathies	8	0.94
Drug addiction	6	0.70
Other comorbidities*	6	0.70

Outcomes	N	%
Pre-hospital death	676	79.34
In-hospital death	140	16.43
Hospital discharge	32	3.76
Transferred	4	0.47
Total	852	100.00

Brain Performance Category	Discharge/Transfer		After 6 months		After 1 year
Brain Performance Category	N	%	N	%	N	%
1 (Good brain performance)	10	27.78	12	33.33	15	41.67
2 (Moderate brain impairment)	11	30.55	9	25.00	6	16.66
3 (Severe brain impairment)	5	13.89	4	11.11	1	2.78
4 (Comatose, vegetative state)	2	5.56	2	5.56	1	2.78
5 (Death)			1	2.78	5	13.89
Follow-up losses	8	22.22	8	22.22	8	22.22
Total	36	100.0	36	100.0	36	100.0

Outcomes	Clinical		External cause		p-value
Outcomes	N	%	N	%	p-value
Pre-hospital death	612	80.31	64	71.11	0.026*
In-hospital death	119	15.62	21	23.34
Hospital discharge	29	3.81	3	3.33
Transferred	2	0.26	2	2.22
Total	762	100.0	90	100.0

Sociedade Brasileira de Cardiologia - SBC Avenida Marechal Câmara, 160, sala: 330, Centro, CEP: 20020-907, (21) 3478-2700 - Rio de Janeiro - RJ - Brazil, Fax: +55 21 3478-2770 - São Paulo - SP - Brazil
E-mail: revista@cardiol.br

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[1] Mailing Address: Daiana Terra Nacer • Universidade de São Paulo – Escola de Enfermagem – Av. Dr. Enéas Carvalho de Aguiar, 419. Postal Code 05403-000, Cerqueira César, São Paulo, SP – Brazil E-mail: daiananacer@hotmail.com