In-hospital mode of death after out-of-hospital cardiac arrest
Introduction: Factors associated with in-hospital mortality after out-of-hospital cardiac arrest (OHCA), such as mode of death and withdrawal of life-sustaining treatment (WLST), are not well established. This study aimed to compare clinical characteristics, timing of WLST and death, and precipitati...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Resuscitation Plus |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520422000297 |
| _version_ | 1811333758865899520 |
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| author | Melanie R Wittwer Thomas Armstrong Jordan Conway Mohammed Ishaq Ruknuddeen Chris Zeitz John F Beltrame Margaret A Arstall |
| author_facet | Melanie R Wittwer Thomas Armstrong Jordan Conway Mohammed Ishaq Ruknuddeen Chris Zeitz John F Beltrame Margaret A Arstall |
| author_sort | Melanie R Wittwer |
| collection | DOAJ |
| description | Introduction: Factors associated with in-hospital mortality after out-of-hospital cardiac arrest (OHCA), such as mode of death and withdrawal of life-sustaining treatment (WLST), are not well established. This study aimed to compare clinical characteristics, timing of WLST and death, and precipitating aetiology between modes of death for OHCAs treated at hospital within a local health network. Methods: Retrospective cohort study of adult non-traumatic OHCAs included in a hospital based OHCA registry between 2011 and 2016 and deceased at hospital discharge, excluding cases retrieved to external hospitals. Mode of death was defined as (1) cardiovascular instability, (2) non-neurological WLST, (3) neurological WLST, and (4) formal brain death. Relevant data were extracted from the registry and stratified according to mode of death and timing of death as early (within the emergency department) or late (after admission). Results: Mode of death data was available for 69 early and 144 late deaths. Cardiovascular instability was the primary mode for 75% of early deaths, while 72% of late deaths were attributed to neurological injury (47% neurological WLST and 24% brain death, combined). Cardiovascular instability was associated with cardiac aetiology, brain death was associated with younger age and highest rates of organ donation, and neurological WLST was associated with highest rates of targeted temperature management, and longest time from arrest to death (p < 0.05). Conclusions: This is the first study to compare clinical characteristics of adult patients resuscitated from OHCA according to in-hospital mode of death. A consensus on the definition of mode of death with standardised classification is needed. |
| first_indexed | 2024-04-13T16:57:45Z |
| format | Article |
| id | doaj.art-70e163901b224a18ab692c5be4482b9d |
| institution | Directory Open Access Journal |
| issn | 2666-5204 |
| language | English |
| last_indexed | 2024-04-13T16:57:45Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj.art-70e163901b224a18ab692c5be4482b9d2022-12-22T02:38:46ZengElsevierResuscitation Plus2666-52042022-06-0110100229In-hospital mode of death after out-of-hospital cardiac arrestMelanie R Wittwer0Thomas Armstrong1Jordan Conway2Mohammed Ishaq Ruknuddeen3Chris Zeitz4John F Beltrame5Margaret A Arstall6Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Northern Adelaide Local Health Network, Elizabeth Vale, South Australia, Australia; Corresponding author at: Department of Cardiology, Lyell McEwin Hospital, Haydown Road, Elizabeth Vale, SA 5112, Australia.Adelaide Medical School, University of Adelaide, Adelaide, South Australia, AustraliaAdelaide Medical School, University of Adelaide, Adelaide, South Australia, AustraliaAdelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Northern Adelaide Local Health Network, Elizabeth Vale, South Australia, AustraliaAdelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Central Adelaide Local Health Network, Adelaide, South Australia, AustraliaAdelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Central Adelaide Local Health Network, Adelaide, South Australia, AustraliaAdelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia; Northern Adelaide Local Health Network, Elizabeth Vale, South Australia, AustraliaIntroduction: Factors associated with in-hospital mortality after out-of-hospital cardiac arrest (OHCA), such as mode of death and withdrawal of life-sustaining treatment (WLST), are not well established. This study aimed to compare clinical characteristics, timing of WLST and death, and precipitating aetiology between modes of death for OHCAs treated at hospital within a local health network. Methods: Retrospective cohort study of adult non-traumatic OHCAs included in a hospital based OHCA registry between 2011 and 2016 and deceased at hospital discharge, excluding cases retrieved to external hospitals. Mode of death was defined as (1) cardiovascular instability, (2) non-neurological WLST, (3) neurological WLST, and (4) formal brain death. Relevant data were extracted from the registry and stratified according to mode of death and timing of death as early (within the emergency department) or late (after admission). Results: Mode of death data was available for 69 early and 144 late deaths. Cardiovascular instability was the primary mode for 75% of early deaths, while 72% of late deaths were attributed to neurological injury (47% neurological WLST and 24% brain death, combined). Cardiovascular instability was associated with cardiac aetiology, brain death was associated with younger age and highest rates of organ donation, and neurological WLST was associated with highest rates of targeted temperature management, and longest time from arrest to death (p < 0.05). Conclusions: This is the first study to compare clinical characteristics of adult patients resuscitated from OHCA according to in-hospital mode of death. A consensus on the definition of mode of death with standardised classification is needed.http://www.sciencedirect.com/science/article/pii/S2666520422000297Out of hospital cardiac arrestMode of deathCause of deathAetiologyWLSTBrain death |
| spellingShingle | Melanie R Wittwer Thomas Armstrong Jordan Conway Mohammed Ishaq Ruknuddeen Chris Zeitz John F Beltrame Margaret A Arstall In-hospital mode of death after out-of-hospital cardiac arrest Resuscitation Plus Out of hospital cardiac arrest Mode of death Cause of death Aetiology WLST Brain death |
| title | In-hospital mode of death after out-of-hospital cardiac arrest |
| title_full | In-hospital mode of death after out-of-hospital cardiac arrest |
| title_fullStr | In-hospital mode of death after out-of-hospital cardiac arrest |
| title_full_unstemmed | In-hospital mode of death after out-of-hospital cardiac arrest |
| title_short | In-hospital mode of death after out-of-hospital cardiac arrest |
| title_sort | in hospital mode of death after out of hospital cardiac arrest |
| topic | Out of hospital cardiac arrest Mode of death Cause of death Aetiology WLST Brain death |
| url | http://www.sciencedirect.com/science/article/pii/S2666520422000297 |
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