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Influence of circulatory shock at hospital admission on outcome after out-of-hospital cardiac arrest

Düring, Joachim LU orcid ; Annborn, Martin LU ; Dankiewicz, Josef LU orcid ; Dupont, Allison ; Forsberg, Sune ; Friberg, Hans LU ; Kern, Karl B. ; May, Teresa L. ; McPherson, John and Patel, Nainesh , et al. (2022) In Scientific Reports 12(1).
Abstract

Hypotension after cardiac arrest could aggravate prolonged hypoxic ischemic encephalopathy. The association of circulatory shock at hospital admission with outcome after cardiac arrest has not been well studied. The objective of this study was to investigate the independent association of circulatory shock at hospital admission with neurologic outcome, and to evaluate whether cardiovascular comorbidities interact with circulatory shock. 4004 adult patients with out-of-hospital cardiac arrest enrolled in the International Cardiac Arrest Registry 2006–2017 were included in analysis. Circulatory shock was defined as a systolic blood pressure below 90 mmHg and/or medical or mechanical supportive measures to maintain adequate perfusion... (More)

Hypotension after cardiac arrest could aggravate prolonged hypoxic ischemic encephalopathy. The association of circulatory shock at hospital admission with outcome after cardiac arrest has not been well studied. The objective of this study was to investigate the independent association of circulatory shock at hospital admission with neurologic outcome, and to evaluate whether cardiovascular comorbidities interact with circulatory shock. 4004 adult patients with out-of-hospital cardiac arrest enrolled in the International Cardiac Arrest Registry 2006–2017 were included in analysis. Circulatory shock was defined as a systolic blood pressure below 90 mmHg and/or medical or mechanical supportive measures to maintain adequate perfusion during hospital admission. Primary outcome was cerebral performance category (CPC) dichotomized as good, (CPC 1–2) versus poor (CPC 3–5) outcome at hospital discharge. 38% of included patients were in circulatory shock at hospital admission, 32% had good neurologic outcome at hospital discharge. The adjusted odds ratio for good neurologic outcome in patients without preexisting cardiovascular disease with circulatory shock at hospital admission was 0.60 [0.46–0.79]. No significant interaction was detected with preexisting comorbidities in the main analysis. We conclude that circulatory shock at hospital admission after out-of-hospital cardiac arrest is independently associated with poor neurologic outcome.

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publishing date
type
Contribution to journal
publication status
published
subject
in
Scientific Reports
volume
12
issue
1
article number
8293
publisher
Nature Publishing Group
external identifiers
  • pmid:35585159
  • scopus:85130292014
ISSN
2045-2322
DOI
10.1038/s41598-022-12310-5
language
English
LU publication?
yes
id
cf54d4b0-64a6-4cec-8eec-6b5128ef566b
date added to LUP
2022-12-29 10:45:28
date last changed
2024-04-18 17:21:25
@article{cf54d4b0-64a6-4cec-8eec-6b5128ef566b,
  abstract     = {{<p>Hypotension after cardiac arrest could aggravate prolonged hypoxic ischemic encephalopathy. The association of circulatory shock at hospital admission with outcome after cardiac arrest has not been well studied. The objective of this study was to investigate the independent association of circulatory shock at hospital admission with neurologic outcome, and to evaluate whether cardiovascular comorbidities interact with circulatory shock. 4004 adult patients with out-of-hospital cardiac arrest enrolled in the International Cardiac Arrest Registry 2006–2017 were included in analysis. Circulatory shock was defined as a systolic blood pressure below 90 mmHg and/or medical or mechanical supportive measures to maintain adequate perfusion during hospital admission. Primary outcome was cerebral performance category (CPC) dichotomized as good, (CPC 1–2) versus poor (CPC 3–5) outcome at hospital discharge. 38% of included patients were in circulatory shock at hospital admission, 32% had good neurologic outcome at hospital discharge. The adjusted odds ratio for good neurologic outcome in patients without preexisting cardiovascular disease with circulatory shock at hospital admission was 0.60 [0.46–0.79]. No significant interaction was detected with preexisting comorbidities in the main analysis. We conclude that circulatory shock at hospital admission after out-of-hospital cardiac arrest is independently associated with poor neurologic outcome.</p>}},
  author       = {{Düring, Joachim and Annborn, Martin and Dankiewicz, Josef and Dupont, Allison and Forsberg, Sune and Friberg, Hans and Kern, Karl B. and May, Teresa L. and McPherson, John and Patel, Nainesh and Seder, David B. and Stammet, Pascal and Sunde, Kjetil and Søreide, Eldar and Ullén, Susann and Nielsen, Niklas}},
  issn         = {{2045-2322}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Scientific Reports}},
  title        = {{Influence of circulatory shock at hospital admission on outcome after out-of-hospital cardiac arrest}},
  url          = {{http://dx.doi.org/10.1038/s41598-022-12310-5}},
  doi          = {{10.1038/s41598-022-12310-5}},
  volume       = {{12}},
  year         = {{2022}},
}