Outcome of in- and out-of-hospital cardiac arrest survivors with liver cirrhosis
Abstract Background Organ failure increases mortality in patients with liver cirrhosis. Data about resuscitated cardiac arrest patients with liver cirrhosis are missing. This study aims to assess aetiology, survival and functional outcome in patients after successful cardiopulmonary resuscitation (C...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2017-10-01
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| Series: | Annals of Intensive Care |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13613-017-0322-1 |
| _version_ | 1818191384892407808 |
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| author | Kevin Roedl Christian Wallmüller Andreas Drolz Thomas Horvatits Karoline Rutter Alexander Spiel Julia Ortbauer Peter Stratil Pia Hubner Christoph Weiser Jasmin Katrin Motaabbed Dominik Jarczak Harald Herkner Fritz Sterz Valentin Fuhrmann |
| author_facet | Kevin Roedl Christian Wallmüller Andreas Drolz Thomas Horvatits Karoline Rutter Alexander Spiel Julia Ortbauer Peter Stratil Pia Hubner Christoph Weiser Jasmin Katrin Motaabbed Dominik Jarczak Harald Herkner Fritz Sterz Valentin Fuhrmann |
| author_sort | Kevin Roedl |
| collection | DOAJ |
| description | Abstract Background Organ failure increases mortality in patients with liver cirrhosis. Data about resuscitated cardiac arrest patients with liver cirrhosis are missing. This study aims to assess aetiology, survival and functional outcome in patients after successful cardiopulmonary resuscitation (CPR) with and without liver cirrhosis. Methods Analysis of prospectively collected cardiac arrest registry data of consecutively hospital-admitted patients following successful CPR was performed. Patient’s characteristics, admission diagnosis, severity of disease, course of disease, short- and long-term mortality as well as functional outcome were assessed and compared between patients with and without cirrhosis. Results Out of 1068 patients with successful CPR, 47 (4%) had liver cirrhosis. Acute-on-chronic liver failure (ACLF) was present in 33 (70%) of these patients on admission, and four patients developed ACLF during follow-up. Mortality at 1 year was more than threefold increased in patients with liver cirrhosis (OR 3.25; 95% CI 1.33–7.96). Liver cirrhosis was associated with impaired neurological outcome (OR for a favourable cerebral performance category: 0.13; 95% CI 0.04–0.36). None of the patients with Child–Turcotte–Pugh (CTP) C cirrhosis survived 28 days with good neurological outcome. Overall nine (19%) patients with cirrhosis survived 28 days with good neurological outcome. All patients with ACLF grade 3 died within 28 days. Conclusion Cardiac arrest survivors with cirrhosis have worse outcome than those without. Although one quarter of patients with liver cirrhosis survived longer than 28 days after successful CPR, patients with CTP C as well as advanced ACLF did not survive 28 days with good neurological outcome. |
| first_indexed | 2024-12-12T00:13:46Z |
| format | Article |
| id | doaj.art-9512f7aefc0041dda2eda885b19faf5d |
| institution | Directory Open Access Journal |
| issn | 2110-5820 |
| language | English |
| last_indexed | 2024-12-12T00:13:46Z |
| publishDate | 2017-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Intensive Care |
| spelling | doaj.art-9512f7aefc0041dda2eda885b19faf5d2022-12-22T00:44:53ZengSpringerOpenAnnals of Intensive Care2110-58202017-10-01711910.1186/s13613-017-0322-1Outcome of in- and out-of-hospital cardiac arrest survivors with liver cirrhosisKevin Roedl0Christian Wallmüller1Andreas Drolz2Thomas Horvatits3Karoline Rutter4Alexander Spiel5Julia Ortbauer6Peter Stratil7Pia Hubner8Christoph Weiser9Jasmin Katrin Motaabbed10Dominik Jarczak11Harald Herkner12Fritz Sterz13Valentin Fuhrmann14Department of Intensive Care Medicine, University Medical Center Hamburg-EppendorfDepartment of Emergency Medicine, Medical University of ViennaDepartment of Intensive Care Medicine, University Medical Center Hamburg-EppendorfDepartment of Intensive Care Medicine, University Medical Center Hamburg-EppendorfDepartment of Intensive Care Medicine, University Medical Center Hamburg-EppendorfDepartment of Intensive Care Medicine, University Medical Center Hamburg-EppendorfDivision of Gastroenterology and Hepatology, Department of Internal Medicine 3, Medical University of ViennaDepartment of Emergency Medicine, Medical University of ViennaDepartment of Emergency Medicine, Medical University of ViennaDepartment of Emergency Medicine, Medical University of ViennaDivision of Gastroenterology and Hepatology, Department of Internal Medicine 3, Medical University of ViennaDepartment of Intensive Care Medicine, University Medical Center Hamburg-EppendorfDepartment of Emergency Medicine, Medical University of ViennaDepartment of Emergency Medicine, Medical University of ViennaDepartment of Intensive Care Medicine, University Medical Center Hamburg-EppendorfAbstract Background Organ failure increases mortality in patients with liver cirrhosis. Data about resuscitated cardiac arrest patients with liver cirrhosis are missing. This study aims to assess aetiology, survival and functional outcome in patients after successful cardiopulmonary resuscitation (CPR) with and without liver cirrhosis. Methods Analysis of prospectively collected cardiac arrest registry data of consecutively hospital-admitted patients following successful CPR was performed. Patient’s characteristics, admission diagnosis, severity of disease, course of disease, short- and long-term mortality as well as functional outcome were assessed and compared between patients with and without cirrhosis. Results Out of 1068 patients with successful CPR, 47 (4%) had liver cirrhosis. Acute-on-chronic liver failure (ACLF) was present in 33 (70%) of these patients on admission, and four patients developed ACLF during follow-up. Mortality at 1 year was more than threefold increased in patients with liver cirrhosis (OR 3.25; 95% CI 1.33–7.96). Liver cirrhosis was associated with impaired neurological outcome (OR for a favourable cerebral performance category: 0.13; 95% CI 0.04–0.36). None of the patients with Child–Turcotte–Pugh (CTP) C cirrhosis survived 28 days with good neurological outcome. Overall nine (19%) patients with cirrhosis survived 28 days with good neurological outcome. All patients with ACLF grade 3 died within 28 days. Conclusion Cardiac arrest survivors with cirrhosis have worse outcome than those without. Although one quarter of patients with liver cirrhosis survived longer than 28 days after successful CPR, patients with CTP C as well as advanced ACLF did not survive 28 days with good neurological outcome.http://link.springer.com/article/10.1186/s13613-017-0322-1Cardiac arrestCirrhosisAcute-on-chronic liver failureMultiple organ failureIntensive care unit |
| spellingShingle | Kevin Roedl Christian Wallmüller Andreas Drolz Thomas Horvatits Karoline Rutter Alexander Spiel Julia Ortbauer Peter Stratil Pia Hubner Christoph Weiser Jasmin Katrin Motaabbed Dominik Jarczak Harald Herkner Fritz Sterz Valentin Fuhrmann Outcome of in- and out-of-hospital cardiac arrest survivors with liver cirrhosis Annals of Intensive Care Cardiac arrest Cirrhosis Acute-on-chronic liver failure Multiple organ failure Intensive care unit |
| title | Outcome of in- and out-of-hospital cardiac arrest survivors with liver cirrhosis |
| title_full | Outcome of in- and out-of-hospital cardiac arrest survivors with liver cirrhosis |
| title_fullStr | Outcome of in- and out-of-hospital cardiac arrest survivors with liver cirrhosis |
| title_full_unstemmed | Outcome of in- and out-of-hospital cardiac arrest survivors with liver cirrhosis |
| title_short | Outcome of in- and out-of-hospital cardiac arrest survivors with liver cirrhosis |
| title_sort | outcome of in and out of hospital cardiac arrest survivors with liver cirrhosis |
| topic | Cardiac arrest Cirrhosis Acute-on-chronic liver failure Multiple organ failure Intensive care unit |
| url | http://link.springer.com/article/10.1186/s13613-017-0322-1 |
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