Abstract 218: Chronic Beta-Blocker Use is Associated With a Non-Shockable Rhythm in Out-of-Hospital Cardiac Arrest and Does Not Improve Survival to Hospital Discharge
Objective: Beta blocker (BB) administration before, during, or after resuscitation from VF cardiac arrest has been shown to be beneficial in experimental models. It is unknown if this benefit extends to the typical clinical population at risk for sudden death. The purpose of this study was to compare arrest rhythms and survival outcomes for out-of-hospital cardiac arrest victims on BB versus those who are not.
Methods: A 36 month retrospective cohort study of non-traumatic cardiac arrest adult patients presenting from 1/2006–12/2009. Study variables included age, gender, pre-arrest BB use, bystander CPR and witness status, arrest rhythm, number of countershocks, hypothermia, and percutaneous coronary intervention (PCI), and survival to hospital discharge (SHD). Wilcoxon rank-sum, chi-square, and logistic regression were used for group comparisons and assessment of outcome predictors. Data are reported as the median and interquartile range or odds ratios.
Results: Seventy-two patients were identified; 30 (42%) were taking BB prior to the arrest. Initial rhythms included VF/VT (33%), PEA (37%), and asystole (29%). For the beta-blocker group, the median age was 74 (67–83) vs. 65 (56–77) in the non-beta-blocker group (p=0.03). There was no significant difference between the two cohorts with respect to gender (p=0.8), bystander CPR (p=0.4), witness (p= 0.3), hypothermia (p= 0.9), number of countershocks (p=0.1), or PCI (p=0.7). Seventeen percent (5/30) of the BB cohort presented with VF/VT, compared to 40% (17/42) of those not on BB (odds ratio for VF = 0.3, 95%CI 0.1–0.9).Thirty percent (9/30) of the BB cohort survived to hospital discharge, whereas 26% (11/42) of those not on BB survived to hospital discharge (odds ratio 1.2, 95%CI 0.4–3.4, p = 0.7). After adjusting for arrest rhythm and age, BB use did not appear to improve survival to hospital discharge with a power of 76%.
Conclusions: BB use is associated with a non-shockable out-of-hospital cardiac arrest rhythm, and beta-blocker use does not appear to improve the survival to hospital discharge rate.
- © 2010 by American Heart Association, Inc.