Death after awakening from post-anoxic coma : The "best CPC" project
(2019) In Critical Care 23(1).- Abstract
Background: In patients who recover consciousness after cardiac arrest (CA), a subsequent death from non-neurological causes may confound the assessment of long-term neurological outcome. We investigated the prevalence and causes of death after awakening (DAA) in a multicenter cohort of CA patients. Methods: Observational multicenter cohort study on patients resuscitated from CA in eight European intensive care units (ICUs) from January 2007 to December 2014. DAA during the hospital stay was extracted retrospectively from patient medical records. Demographics, comorbidities, initial CA characteristics, concomitant therapies, prognostic tests (clinical examination, electroencephalography (EEG), somatosensory evoked potentials (SSEPs)),... (More)
Background: In patients who recover consciousness after cardiac arrest (CA), a subsequent death from non-neurological causes may confound the assessment of long-term neurological outcome. We investigated the prevalence and causes of death after awakening (DAA) in a multicenter cohort of CA patients. Methods: Observational multicenter cohort study on patients resuscitated from CA in eight European intensive care units (ICUs) from January 2007 to December 2014. DAA during the hospital stay was extracted retrospectively from patient medical records. Demographics, comorbidities, initial CA characteristics, concomitant therapies, prognostic tests (clinical examination, electroencephalography (EEG), somatosensory evoked potentials (SSEPs)), and cause of death were identified. Results: From a total 4646 CA patients, 2478 (53%) died in-hospital, of whom 196 (4.2%; ranges 0.6-13.0%) had DAA. DAA was less frequent among out-of-hospital than in-hospital CA (82/2997 [2.7%] vs. 114/1649 [6.9%]; p < 0.001). Median times from CA to awakening and from awakening to death were 2 [1-5] and 9 [3-18] days, respectively. The main causes of DAA were multiple organ failure (n = 61), cardiogenic shock (n = 61), and re-arrest (n = 26). At day 3 from admission, results from EEG (n = 56) and SSEPs (n = 60) did not indicate poor outcome. Conclusions: In this large multicenter cohort, DAA was observed in 4.2% of non-survivors. Information on DAA is crucial since it may influence epidemiology and the design of future CA studies evaluating neuroprognostication and neuroprotection.
(Less)
- author
- Taccone, Fabio Silvio ; Horn, Janneke ; Storm, Christian ; Cariou, Alain ; Sandroni, Claudio ; Friberg, Hans LU ; Hoedemaekers, Cornelia Astrid and Oddo, Mauro
- organization
- publishing date
- 2019-04-03
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Awakening, Cardiac arrest, Outcome, Prognostication
- in
- Critical Care
- volume
- 23
- issue
- 1
- article number
- 107
- publisher
- BioMed Central (BMC)
- external identifiers
-
- scopus:85063964745
- pmid:30944013
- ISSN
- 1364-8535
- DOI
- 10.1186/s13054-019-2405-x
- language
- English
- LU publication?
- yes
- id
- 4d4bdcb6-aa62-4b33-b212-10ac8df9a883
- date added to LUP
- 2019-04-25 12:57:27
- date last changed
- 2024-07-10 13:11:01
@article{4d4bdcb6-aa62-4b33-b212-10ac8df9a883,
abstract = {{<p>Background: In patients who recover consciousness after cardiac arrest (CA), a subsequent death from non-neurological causes may confound the assessment of long-term neurological outcome. We investigated the prevalence and causes of death after awakening (DAA) in a multicenter cohort of CA patients. Methods: Observational multicenter cohort study on patients resuscitated from CA in eight European intensive care units (ICUs) from January 2007 to December 2014. DAA during the hospital stay was extracted retrospectively from patient medical records. Demographics, comorbidities, initial CA characteristics, concomitant therapies, prognostic tests (clinical examination, electroencephalography (EEG), somatosensory evoked potentials (SSEPs)), and cause of death were identified. Results: From a total 4646 CA patients, 2478 (53%) died in-hospital, of whom 196 (4.2%; ranges 0.6-13.0%) had DAA. DAA was less frequent among out-of-hospital than in-hospital CA (82/2997 [2.7%] vs. 114/1649 [6.9%]; p < 0.001). Median times from CA to awakening and from awakening to death were 2 [1-5] and 9 [3-18] days, respectively. The main causes of DAA were multiple organ failure (n = 61), cardiogenic shock (n = 61), and re-arrest (n = 26). At day 3 from admission, results from EEG (n = 56) and SSEPs (n = 60) did not indicate poor outcome. Conclusions: In this large multicenter cohort, DAA was observed in 4.2% of non-survivors. Information on DAA is crucial since it may influence epidemiology and the design of future CA studies evaluating neuroprognostication and neuroprotection.</p>}},
author = {{Taccone, Fabio Silvio and Horn, Janneke and Storm, Christian and Cariou, Alain and Sandroni, Claudio and Friberg, Hans and Hoedemaekers, Cornelia Astrid and Oddo, Mauro}},
issn = {{1364-8535}},
keywords = {{Awakening; Cardiac arrest; Outcome; Prognostication}},
language = {{eng}},
month = {{04}},
number = {{1}},
publisher = {{BioMed Central (BMC)}},
series = {{Critical Care}},
title = {{Death after awakening from post-anoxic coma : The "best CPC" project}},
url = {{http://dx.doi.org/10.1186/s13054-019-2405-x}},
doi = {{10.1186/s13054-019-2405-x}},
volume = {{23}},
year = {{2019}},
}