Abstract 17196: Incidence and Clinical Implications of Pneumonia in Comatose Survivors of Out-of-hospital Cardiac Arrest: Insights From University of Ottawa Heart Institute Cardiac Arrest Registry
Background: Health-care associated pneumonia is a common complication in comatose survivors of out-of-hospital cardiac arrest (OHCA). However, the effect of pneumonia on the hospital course and clinical outcomes of OHCA patients has not been well studied.
Methods: We identified consecutive patients undergoing targeted temperature management following OHCA secondary to a shockable rhythm (ventricular tachycardia or fibrillation). To address survival bias we excluded patients who died within 48 hours of hospital admission. We then compared clinical outcomes between patients with and without pneumonia. The primary outcome was severe neurologic dysfunction as defined by a cerebral performance category (CPC) ≥3; secondary outcomes included duration of mechanical ventilation and length of stay in hospital and in the cardiac intensive care unit (CICU).
Results: Of 116 patients included (mean age 57 years, mean downtime 24 min, 22% female, 47% STEMI), 87 (75%) developed pneumonia. Patients who developed pneumonia were older; baseline patient and index event characteristics were otherwise comparable between the two cohorts. The most common pathogens isolated included Staphylococcus aureus, Haemophilus influenza, Streptococcal species and Klebsiella species. Piperacillin/tazobactam and cephalosporins were used to treat the majority of patients. The incidence of the primary outcome (28%) was comparable in patients with versus without pneumonia. However, compared to patients without pneumonia, OHCA patients with pneumonia required longer periods of mechanical ventilation and longer lengths of stay in hospital and in the CICU.
Conclusions: Pneumonia after OHCA is common. There was no association between the development of pneumonia and the odds of severe neurologic dysfunction following OHCA. However, OHCA patients who developed pneumonia required a longer duration of mechanical ventilation and had longer lengths of stay in hospital and in the CICU.
Author Disclosures: J.J. Russo: None. H. Rizk: None. C. Osborne: None. T.E. James: None. B. Hibbert: None. D.Y. So: None. M. Froeschl: None. M. Labinaz: None. C. Glover: None. A. Chong: None. J. Marquis: None. A. Dick: None. M.R. Le May: None.
- © 2016 by American Heart Association, Inc.