Long-term survival among OHCA patients who survive to 30 days: Does initial arrest rhythm remain a prognostic determinant?
Objective: To determine whether initial cardiac arrest rhythm remains a prognostic determinant in longer term OHCA survival. Methods: The St John Western Australian OHCA database was used to identify adults who survived for at least 30 days after an OHCA of presumed medical aetiology, in the Perth m...
| Main Authors: | , , , , |
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| Format: | Journal Article |
| Language: | English |
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ELSEVIER IRELAND LTD
2021
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1116453 http://hdl.handle.net/20.500.11937/93324 |
| _version_ | 1848765720832245760 |
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| author | Majewski, David Ball, Stephen Bailey, P. Bray, Janet Finn, Judith |
| author_facet | Majewski, David Ball, Stephen Bailey, P. Bray, Janet Finn, Judith |
| author_sort | Majewski, David |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objective: To determine whether initial cardiac arrest rhythm remains a prognostic determinant in longer term OHCA survival. Methods: The St John Western Australian OHCA database was used to identify adults who survived for at least 30 days after an OHCA of presumed medical aetiology, in the Perth metropolitan area between 1998 and 2017. Associations between 8-year OHCA survival and variables of interest were analysed using a Multi-Resolution Hazard (MRH) estimator model with 1-year intervals. Results: Of the 871 OHCA patients who survived 30 days, 718 (82%) presented with a shockable initial arrest rhythm and 153 (18%) presented with a non-shockable rhythm. Compared to patients with initial shockable arrests, patients with non-shockable arrests experienced increased mortality in the first (HR 3.33, 95% CI 2.12−5.32), second (HR 2.58, 95% CI 1.22−5.15), third (HR 2.21, 95% CI 1.02−4.42) and fourth (HR 2.21, 95% CI 1.02−4.42) year post arrest; however, in subsequent years the initial arrest rhythm ceased to be significantly associated with survival. The overall 8-year survival estimates after adjustment for peri-arrest factors (as potential confounders) were 87% (95% CI 77–93%) for shockable arrests and 73% (95% CI 55–86%) for non-shockable arrests. Conclusions: Patients with non-shockable (as opposed to shockable) initial arrest rhythms experienced higher mortality in the first 4-years following their OHCA; however, after four years the initial arrest rhythm ceased to be associated with survival. |
| first_indexed | 2025-11-14T11:39:44Z |
| format | Journal Article |
| id | curtin-20.500.11937-93324 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:39:44Z |
| publishDate | 2021 |
| publisher | ELSEVIER IRELAND LTD |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-933242023-10-11T00:49:57Z Long-term survival among OHCA patients who survive to 30 days: Does initial arrest rhythm remain a prognostic determinant? Majewski, David Ball, Stephen Bailey, P. Bray, Janet Finn, Judith Science & Technology Life Sciences & Biomedicine Critical Care Medicine Emergency Medicine General & Internal Medicine Out of hospital cardiac arrest Arrest rhythm Long-term survival HOSPITAL CARDIAC-ARREST MULTIRESOLUTION HAZARD MODEL RESUSCITATION ASSOCIATION PREDICTORS HEART Arrest rhythm Long-term survival Out of hospital cardiac arrest Adult Australia Cardiopulmonary Resuscitation Electric Countershock Emergency Medical Services Humans Out-of-Hospital Cardiac Arrest Prognosis Humans Prognosis Electric Countershock Cardiopulmonary Resuscitation Adult Emergency Medical Services Australia Out-of-Hospital Cardiac Arrest Objective: To determine whether initial cardiac arrest rhythm remains a prognostic determinant in longer term OHCA survival. Methods: The St John Western Australian OHCA database was used to identify adults who survived for at least 30 days after an OHCA of presumed medical aetiology, in the Perth metropolitan area between 1998 and 2017. Associations between 8-year OHCA survival and variables of interest were analysed using a Multi-Resolution Hazard (MRH) estimator model with 1-year intervals. Results: Of the 871 OHCA patients who survived 30 days, 718 (82%) presented with a shockable initial arrest rhythm and 153 (18%) presented with a non-shockable rhythm. Compared to patients with initial shockable arrests, patients with non-shockable arrests experienced increased mortality in the first (HR 3.33, 95% CI 2.12−5.32), second (HR 2.58, 95% CI 1.22−5.15), third (HR 2.21, 95% CI 1.02−4.42) and fourth (HR 2.21, 95% CI 1.02−4.42) year post arrest; however, in subsequent years the initial arrest rhythm ceased to be significantly associated with survival. The overall 8-year survival estimates after adjustment for peri-arrest factors (as potential confounders) were 87% (95% CI 77–93%) for shockable arrests and 73% (95% CI 55–86%) for non-shockable arrests. Conclusions: Patients with non-shockable (as opposed to shockable) initial arrest rhythms experienced higher mortality in the first 4-years following their OHCA; however, after four years the initial arrest rhythm ceased to be associated with survival. 2021 Journal Article http://hdl.handle.net/20.500.11937/93324 10.1016/j.resuscitation.2021.02.030 English http://purl.org/au-research/grants/nhmrc/1116453 http://purl.org/au-research/grants/nhmrc/1174838 http://creativecommons.org/licenses/by-nc-nd/4.0/ ELSEVIER IRELAND LTD fulltext |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Critical Care Medicine Emergency Medicine General & Internal Medicine Out of hospital cardiac arrest Arrest rhythm Long-term survival HOSPITAL CARDIAC-ARREST MULTIRESOLUTION HAZARD MODEL RESUSCITATION ASSOCIATION PREDICTORS HEART Arrest rhythm Long-term survival Out of hospital cardiac arrest Adult Australia Cardiopulmonary Resuscitation Electric Countershock Emergency Medical Services Humans Out-of-Hospital Cardiac Arrest Prognosis Humans Prognosis Electric Countershock Cardiopulmonary Resuscitation Adult Emergency Medical Services Australia Out-of-Hospital Cardiac Arrest Majewski, David Ball, Stephen Bailey, P. Bray, Janet Finn, Judith Long-term survival among OHCA patients who survive to 30 days: Does initial arrest rhythm remain a prognostic determinant? |
| title | Long-term survival among OHCA patients who survive to 30 days: Does initial arrest rhythm remain a prognostic determinant? |
| title_full | Long-term survival among OHCA patients who survive to 30 days: Does initial arrest rhythm remain a prognostic determinant? |
| title_fullStr | Long-term survival among OHCA patients who survive to 30 days: Does initial arrest rhythm remain a prognostic determinant? |
| title_full_unstemmed | Long-term survival among OHCA patients who survive to 30 days: Does initial arrest rhythm remain a prognostic determinant? |
| title_short | Long-term survival among OHCA patients who survive to 30 days: Does initial arrest rhythm remain a prognostic determinant? |
| title_sort | long-term survival among ohca patients who survive to 30 days: does initial arrest rhythm remain a prognostic determinant? |
| topic | Science & Technology Life Sciences & Biomedicine Critical Care Medicine Emergency Medicine General & Internal Medicine Out of hospital cardiac arrest Arrest rhythm Long-term survival HOSPITAL CARDIAC-ARREST MULTIRESOLUTION HAZARD MODEL RESUSCITATION ASSOCIATION PREDICTORS HEART Arrest rhythm Long-term survival Out of hospital cardiac arrest Adult Australia Cardiopulmonary Resuscitation Electric Countershock Emergency Medical Services Humans Out-of-Hospital Cardiac Arrest Prognosis Humans Prognosis Electric Countershock Cardiopulmonary Resuscitation Adult Emergency Medical Services Australia Out-of-Hospital Cardiac Arrest |
| url | http://purl.org/au-research/grants/nhmrc/1116453 http://purl.org/au-research/grants/nhmrc/1116453 http://hdl.handle.net/20.500.11937/93324 |