Advertisement

Outcome after Cardiopulmonary Resuscitation

  • C. J. R. Gough
  • J. P. Nolan
Part of the Annual Update in Intensive Care and Emergency Medicine book series (AUICEM)

Introduction

Cardiac arrest is an absolute medical emergency. Unless effective cardiopulmonary resuscitation (CPR) is commenced within minutes, death or permanent brain injury will follow. Almost all critical care clinicians will treat cardiac arrest patients. This chapter summarizes the incidence, trends, and short‐ and long‐term survival from both out‐of‐hospital (OHCA) and in‐hospital (IHCA) cardiac arrest.

Out‐of‐Hospital Cardiac Arrest

Incidence

The incidence of emergency medical services (EMS)‐treated OHCA varies significantly around the world (Table  1). A large review of 67 prospective studies, of over 100 million patients, identified wide variation in incidence of cardiac arrest across the globe, but the overall incidence for adults was 62 cases per 100,000 person‐years, with the highest rates in North America (71 per 100,000 person‐years) and the lowest rates in Asia (50 per 100,000 person‐years) [ 1]. Roughly three quarters of cardiac arrests had a cardiac cause.
Table 1

Intern...

References

  1. 1.
    Berdowski J, Berg RA, Tijssen JG, Koster RW (2010) Global incidences of out-of-hospital cardiac arrest and survival rates: systematic review of 67 prospective studies. Resuscitation 81:1479–1487CrossRefGoogle Scholar
  2. 2.
    Nichol G, Thomas E, Callaway CW et al (2008) Regional variation in out-of-hospital cardiac arrest incidence and outcome. JAMA 300:1423–1431CrossRefGoogle Scholar
  3. 3.
    Girotra S, van Diepen S, Nallamothu BK et al (2016) Regional variation in out-of-hospital cardiac arrest survival in the United States. Circulation 133:2159–2168CrossRefGoogle Scholar
  4. 4.
    Grasner JT, Lefering R, Koster RW et al (2016) EuReCa ONE-27 Nations, ONE Europe, ONE Registry: a prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe. Resuscitation 105:188–195CrossRefGoogle Scholar
  5. 5.
    Weisfeldt ML, Everson-Stewart S, Sitlani C et al (2011) Ventricular tachyarrhythmias after cardiac arrest in public versus at home. N Engl J Med 364:313–321CrossRefGoogle Scholar
  6. 6.
    Chan PS, McNally B, Tang F, Kellermann A, Group CS (2014) Recent trends in survival from out-of-hospital cardiac arrest in the United States. Circulation 130:1876–1882CrossRefGoogle Scholar
  7. 7.
    Daya MR, Schmicker RH, Zive DM et al (2015) Out-of-hospital cardiac arrest survival improving over time: results from the Resuscitation Outcomes Consortium (ROC). Resuscitation 91:108–115CrossRefGoogle Scholar
  8. 8.
    Wissenberg M, Lippert FK, Folke F et al (2013) Association of national initiatives to improve cardiac arrest management with rates of bystander intervention and patient survival after out-of-hospital cardiac arrest. JAMA 310:1377–1384CrossRefGoogle Scholar
  9. 9.
    Bougouin W, Lamhaut L, Marijon E et al (2014) Characteristics and prognosis of sudden cardiac death in greater paris : population-based approach from the paris sudden death expertise center (paris-SDEC). Intensive Care Med 40:846–854CrossRefGoogle Scholar
  10. 10.
    Blom MT, Beesems SG, Homma PC et al (2014) Improved survival after out-of-hospital cardiac arrest and use of automated external defibrillators. Circulation 130:1868–1875CrossRefGoogle Scholar
  11. 11.
    Hawkes C, Booth S, Ji C et al (2017) Epidemiology and outcomes from out-of-hospital cardiac arrests in England. Resuscitation 110:133–140CrossRefGoogle Scholar
  12. 12.
    Okubo M, Kiyohara K, Iwami T, Callaway CW, Kitamura T (2017) Nationwide and regional trends in survival from out-of-hospital cardiac arrest in Japan: A 10-year cohort study from 2005 to 2014. Resuscitation 115:120–128CrossRefGoogle Scholar
  13. 13.
    Rajan S, Folke F, Hansen SM et al (2017) Incidence and survival outcome according to heart rhythm during resuscitation attempt in out-of-hospital cardiac arrest patients with presumed cardiac etiology. Resuscitation 114:157–163CrossRefGoogle Scholar
  14. 14.
    Fugate JE, Brinjikji W, Mandrekar JN et al (2012) Post-cardiac arrest mortality is declining: a study of the US National Inpatient Sample 2001 to 2009. Circulation 126:546–550CrossRefGoogle Scholar
  15. 15.
    Kitamura T, Iwami T, Kawamura T et al (2012) Nationwide improvements in survival from out-of-hospital cardiac arrest in Japan. Circulation 126:2834–2843CrossRefGoogle Scholar
  16. 16.
    Virdi G, Picton S, Fothergill R, Whitbread M (2016) Cardiac arrest annual report: 2015/16. London Ambulance Service, LondonGoogle Scholar
  17. 17.
    Nolan JP, Ferrando P, Soar J et al (2016) Increasing survival after admission to UK critical care units following cardiopulmonary resuscitation. Crit Care 20:219CrossRefGoogle Scholar
  18. 18.
    Cronberg T, Lilja G, Horn J et al (2015) Neurologic function and health-related quality of life in patients following targeted temperature management at 33 degrees C vs 36 degrees C after out-of-hospital cardiac arrest: a randomized clinical trial. JAMA Neurol 72:634–641CrossRefGoogle Scholar
  19. 19.
    Lilja G, Nielsen N, Friberg H et al (2015) Cognitive function in survivors of out-of-hospital cardiac arrest after target temperature management at 33 degrees C versus 36 degrees C. Circulation 131:1340–1349CrossRefGoogle Scholar
  20. 20.
    Stiell IG, Nichol G, Leroux BG et al (2011) Early versus later rhythm analysis in patients with out-of-hospital cardiac arrest. N Engl J Med 365:787–797CrossRefGoogle Scholar
  21. 21.
    Kudenchuk PJ, Brown SP, Daya M et al (2016) Amiodarone, lidocaine, or placebo in out-of-hospital cardiac arrest. N Engl J Med 374:1711–1722CrossRefGoogle Scholar
  22. 22.
    Nichol G, Leroux B, Wang H et al (2015) Trial of continuous or interrupted chest compressions during CPR. N Engl J Med 373:2203–2214CrossRefGoogle Scholar
  23. 23.
    Arrich J, Zeiner A, Sterz F et al (2009) Factors associated with a change in functional outcome between one month and six months after cardiac arrest: a retrospective cohort study. Resuscitation 80:876–880CrossRefGoogle Scholar
  24. 24.
    Lund-Kordahl I, Olasveengen TM, Lorem T, Samdal M, Wik L, Sunde K (2010) Improving outcome after out-of-hospital cardiac arrest by strengthening weak links of the local Chain of Survival; quality of advanced life support and post-resuscitation care. Resuscitation 81:422–426CrossRefGoogle Scholar
  25. 25.
    Kragholm K, Wissenberg M, Mortensen RN et al (2015) Return to work in out-of-hospital cardiac arrest survivors: a nationwide register-based follow-up study. Circulation 131:1682–1690CrossRefGoogle Scholar
  26. 26.
    Andrew E, Nehme Z, Wolfe R, Bernard S, Smith K (2017) Long-term survival following out-of-hospital cardiac arrest. Heart 103:1104–1110CrossRefGoogle Scholar
  27. 27.
    Sandroni C, Nolan J, Cavallaro F, Antonelli M (2007) In-hospital cardiac arrest: incidence, prognosis and possible measures to improve survival. Intensive Care Med 33:237–245CrossRefGoogle Scholar
  28. 28.
    Peberdy MA, Kaye W, Ornato JP et al (2003) Cardiopulmonary resuscitation of adults in the hospital: a report of 14720 cardiac arrests from the National Registry of Cardiopulmonary Resuscitation. Resuscitation 58:297–308CrossRefGoogle Scholar
  29. 29.
    Chen LM, Nallamothu BK, Spertus JA, Li Y, Chan PS (2013) Association between a hospital’s rate of cardiac arrest incidence and cardiac arrest survival. JAMA Intern Med 173:1186–1195CrossRefGoogle Scholar
  30. 30.
    Girotra S, Nallamothu BK, Spertus JA et al (2012) Trends in survival after in-hospital cardiac arrest. N Engl J Med 367:1912–1920CrossRefGoogle Scholar
  31. 31.
    Nolan JP, Soar J, Smith GB et al (2014) Incidence and outcome of in-hospital cardiac arrest in the United Kingdom National Cardiac Arrest Audit. Resuscitation 85:987–992CrossRefGoogle Scholar
  32. 32.
    Shao F, Li CS, Liang LR et al (2016) Incidence and outcome of adult in-hospital cardiac arrest in Beijing, China. Resuscitation 102:51–56CrossRefGoogle Scholar
  33. 33.
    Mallikethi-Reddy S, Briasoulis A, Akintoye E et al (2017) Incidence and survival after in-hospital cardiopulmonary resuscitation in nonelderly adults: US experience, 2007 to 2012. Circ Cardiovasc Qual Outcomes 10:e003194CrossRefGoogle Scholar
  34. 34.
    Nolan JP, Soar J, Cariou A et al (2015) European resuscitation council and European Society of Intensive Care Medicine guidelines for post-resuscitation care 2015: section 5 of the European Resuscitation Council Guidelines for Resuscitation 2015. Resuscitation 95:202–222CrossRefGoogle Scholar
  35. 35.
    Feingold P, Mina MJ, Burke RM et al (2016) Long-term survival following in-hospital cardiac arrest: a matched cohort study. Resuscitation 99:72–78CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of Anaesthesia and Intensive Care MedicineRoyal United HospitalBathUK
  2. 2.School of Clinical SciencesUniversity of BristolBristolUK

Personalised recommendations