The American journal of emergency medicine · 2014
Therapeutic hypothermia after cardiac arrest caused by self-inflicted intoxication: a multicenter retrospective cohort study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Kim Han Joon, Kim Gi Woon, Oh Sang Hoon, Park Sang Hyun, Choi Jae Hyung, Kim Kyung Hwan, Jeon Woo Chan, Lee Hui Jai, Park Kyu Nam, Korean Hypothermia Network Investigators
Аннотация
INTRODUCTION: The aim of this study was to describe the epidemiology and outcomes of patients with therapeutic hypothermia after out-of-hospital cardiac arrest (OHCA) caused by self-inflicted intoxication.
METHODS: We performed a multicenter retrospective registry-based study of adult OHCA patients presenting to 24 hospitals over 6 years across South Korea. Data included demographics, resuscitation variables, postresuscitation variables, and self-inflicted intoxicants. Neurologic outcomes were categorized according to the Glasgow-Pittsburgh Cerebral Performance Categories (CPC) scale and were dichotomized as either good discharge outcomes (CPC 1 and 2) or poor discharge outcomes (CPC 3-5).
RESULTS: A total of 930 OHCA cases were identified, 24 (2.6%) of which were classified as cardiac arrest caused by acute intoxication. The mean age of cases was 57.2 ± 12.9 years. The mean time from collapse to return of spontaneous circulation was 35.4 ± 18.7 minutes. The presenting rhythm was pulseless electrical activity in 6 patients (25%) and asystole in 18 patients (75%). Eleven patients (46%) survived to hospital discharge, and of these, good discharge outcomes (CPC 1 and 2) were achieved in 21% (5/24). For pesticide intoxication, the survival-to-discharge rate was 62% (8/13), and the rate of good neurologic outcome was 23% (3/13).
CONCLUSION: Patients with OHCA caused by self-inflicted intoxication represented 2.6% of all OHCA patients. They showed a high rate of unwitnessed cardiac arrest and a very low rate of bystander cardiopulmonary resuscitation. Pesticides were the main cause of cardiac arrest, and these cases had a very high discharge to survival rate.
METHODS: We performed a multicenter retrospective registry-based study of adult OHCA patients presenting to 24 hospitals over 6 years across South Korea. Data included demographics, resuscitation variables, postresuscitation variables, and self-inflicted intoxicants. Neurologic outcomes were categorized according to the Glasgow-Pittsburgh Cerebral Performance Categories (CPC) scale and were dichotomized as either good discharge outcomes (CPC 1 and 2) or poor discharge outcomes (CPC 3-5).
RESULTS: A total of 930 OHCA cases were identified, 24 (2.6%) of which were classified as cardiac arrest caused by acute intoxication. The mean age of cases was 57.2 ± 12.9 years. The mean time from collapse to return of spontaneous circulation was 35.4 ± 18.7 minutes. The presenting rhythm was pulseless electrical activity in 6 patients (25%) and asystole in 18 patients (75%). Eleven patients (46%) survived to hospital discharge, and of these, good discharge outcomes (CPC 1 and 2) were achieved in 21% (5/24). For pesticide intoxication, the survival-to-discharge rate was 62% (8/13), and the rate of good neurologic outcome was 23% (3/13).
CONCLUSION: Patients with OHCA caused by self-inflicted intoxication represented 2.6% of all OHCA patients. They showed a high rate of unwitnessed cardiac arrest and a very low rate of bystander cardiopulmonary resuscitation. Pesticides were the main cause of cardiac arrest, and these cases had a very high discharge to survival rate.