Abstract 44: Prevalence of Cardiac Catheterization and Outcomes From Out-of-Hospital Cardiac Arrest in a Consortium of Cardiac Receiving Centers
Background: Preliminary studies suggest percutaneous coronary intervention (PCI) after out-of-hospital cardiac arrest (OHCA) may be associated with improved outcomes. In Arizona, we have established a statewide system of Cardiac Receiving Centers (CRCs). Here we describe the rate of post-arrest cardiac catheterization (cath) and patient outcomes.
Methods: Participation as a CRC requires a therapeutic hypothermia (TH) protocol, emergent cardiology consultation with consideration for cath, 24/7 PCI capability, and submission of standardized data for each OHCA patient. Statewide data on post-arrest TH and cath were compiled in a database and linked to an Utstein-style OHCA registry. Post-arrest cath and outcomes were analyzed for consecutive adult (≥18 yrs) OHCAs transported to 33 CRCs. Patients who died within 2 hours of hospital arrival were excluded since the likelihood of cath impacting outcome in these patients is questionable.
Results: 855 adult OHCA patients with outcomes available were taken to CRCs between 1/01/08 and 02/17/10. Mean age was 62 years and 63% were male. Overall, 24% (209/855) survived to discharge, 28% (235/855) received TH, and 17% (142/855) underwent cath. Among cath patients, 62% (88/142, 95% CI 54%–69%) survived vs. 17% (121/713, 95% CI 14%–20%, of those without cath; p<0.001). Multivariate analysis is in progress to determine the influence of various factors on survival.
Conclusions: A considerable proportion of OHCA victims in our statewide system underwent cath. Our data suggest a correlation between cath and survival. Further study is needed to determine whether risk-adjusted outcomes are impacted by cath in post-arrest patients.
- © 2010 by American Heart Association, Inc.