Abstract P133: Out-of-Hospital Sudden Cardiac Death Patients Who Undergo Cardiac Catheterization Demonstrate Improved Survival and Neurological Outcomes
Background: Sudden cardiac death (SCD) is a major cause of mortality in the United States, and in-hospital mortality for successfully resuscitated patients remains high. Our hospital is a level one cardiovascular center in a major metropolitan area and receives the majority of SCD patients in the region. The purpose of this study was to evaluate whether SCD patients who undergo cardiac catheterization demonstrated significantly improved survival or neurological outcomes.
Methods: 205 consecutive SCD patients admitted to our hospital from 2004 –2007 were evaluated. Using Chi-squared univariate analyses, we compared patients that underwent cardiac catheterization versus those that did not. We also performed a subanalysis comparing patients that underwent cardiac catheterization within three hours of hospital arrival versus those that underwent cardiac catheterization after the initial three-hour period. Primary endpoints included survival and neurological outcome (using the previously validated CPC score).
Results: The patient group that underwent cardiac catheterization demonstrated significantly improved survival (65.9% vs. 32.7%, p<0.0001) and favorable neurological outcomes (61.2% vs. 18.8%, p<0.0001). Within this group, patients who underwent cardiac catheterization after the initial three-hour period from admission demonstrated improved survival (79.1% vs. 48.5%, p=0.0083). Favorable neurological outcomes did not differ between the early and late cardiac catheterization groups (68.3% vs. 65%, p=0.9374).
Conclusions: In a consecutive population with out-of-hospital sudden cardiac death, patients undergoing cardiac catheterization demonstrated improved survival and favorable neurological outcomes. We also found that patients undergoing late cardiac catheterization showed improved survival. Given the relatively high survival rate in both late and early cardiac catheterization groups, we hypothesize that the late group showed improved survival due to a selection bias of patients who had early in-hospital survival. Our findings suggest that further studies should be done to determine whether routine cardiac catheterization should be included in an initial treatment approach to sudden cardiac death.