0034: Factors predictive of survival after out-of-hospital cardiac arrest

BackgroundThe incidence of acute coronary occlusion in the patients admitted to hospital after out-of-hospital cardiac is high. Several therapeutic elements such as early reperfusion developed in recent years to reduce the high morbidity and mortality observed in this situation. The objective of this study was to evaluate the prognostic factors of survival in a series of patients who underwent coronary angiography in the immediate after out-of-hospital cardiac arrest.MethodsAll patients admitted following an out-of-hospital cardiac arrest from January 2012 to June 2013 were included. The circumstances of the cardiac arrest, data taking pre-hospital care, clinical examination, laboratory parameters, results coronary angiography and the survival rate were investigated. Survival analyses were conducted using Kaplan-Meier estimates and multivariable Cox regression to search predictors of survival.Results54 patients were successfully resuscitated, admitted to hospital and taken directly to the coronary angiography unit, the in-hospital survival rate was 48%. According to multivariate analysis, the factors predictive of survival in general population were ventricular fibrillation or ventricular tachycardia as initial rhythm (p<0.001), troponin level <16mg /l (p=0.055) and the presence of a professional among bystander. In coronary patients, predictors of mortality were: troponin levels> 16mg / l (p=0.02), the presence of one bystander (p=0.02) and the absence of therapeutic hypothermia (p=0.03) and revascularization (p=0.006).ConclusionsIn this cohort study, the survival rate is influenced by factors related to the taking pre-hospital care. We found also that an immediate PCI improves the survival rate of these patients, independently of other usual prognostic factors