Abstract 2836: Early Pronostic Factors of Survivors of Out-of Hospital Cardiac Arrest
Rationale: Despite recent advances, prognosis of patients successfully resuscitated from an OHCA remains very poor, particularly because of early shock and post-anoxic brain damages. A better estimate of outcome at time of ICU admission could help to improve the process of care and communication with proxies. We aimed to determine the main prognosis factors in a large population of post-OHCA patients.
Methods: Between January 2000 and August 2008, all consecutive initial survivors of an OHCA that occurred in large urban area were referred to a tertiary center in Paris and were prospectively included in the study. Outcome was assessed by scoring the Cerebral Performance Categories (CPC) scale at ICU discharge, classifying CPC 1 and 2 as “good outcome” and CPC 3–5 as “bad outcome”. Logistic regression was used to assess the pre-hospital and admission characteristics associated with prognosis.
Results: Among the 983 patients admitted during this period, 690 (70.2%) had a bad outcome during their ICU stay. Independent predictors of bad outcome of these patients were an older age (OR= 1.03;[1.01–1.04], p=0.001), diabetes mellitus (OR=2.56;[1.04 – 4.62];p=0.002), a longer interval between collapse and BLS (OR=3.65;[2.35–5.66];p=0.001); a longer interval between BLS and ROSC (OR=3.30;[2.19 – 4.98];p=0.001), an asphyxia as etiology of cardiac arrest (OR=3.81; [2.3– 6.31];p=0.001], and a high blood lactate (OR=2.60;[2.05–3.3]; p=0.001).
Conclusions: Estimation of prognosis can be improved at time of ICU admission, mainly based on cardiac arrest characteristics and resuscitation performances. The role of diabetes as a detrimental prognosis factor will be investigated in further analyses.