Out-of-Hospital Cardiac Arrest 30-Day-Outcomes: The Importance of the First Electrocardiogram After Successful Resuscitation

IF 1.2 4区医学 Q3 EMERGENCY MEDICINE

Journal of Emergency Medicine Pub Date : 2025-04-01 DOI:10.1016/j.jemermed.2024.09.010

Eimo Martens , Giulio Mastella MD , Daniela Simson , Petra Barthel , Anna Saleki MD , Franziska Hahn , Michael Dommasch PD , Marharyta Pavliuchenko , David Federle , Julia Allescher , Tobias Haufe , Jan Andreas Köhlen , Alexander Müller , Karl-Ludwig Laugwitz , Christian Kupatt , Alexander Steger

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引用次数: 0

Abstract

Background

While there is substantial evidence on the impact of prehospital resuscitation efforts on survival after out-of-hospital cardiac arrest (OHCA), the importance of the first electrocardiogram after return of spontaneous circulation has been much less studied.

Objectives

The aim of this study was to identify prognostically relevant electrocardiographic findings in patients after OHCA due to myocardial infarction (MI).

Methods

A total of 119 patients admitted to hospital after suffering an OHCA due to MI were retrospectively analyzed. Patient characteristics and the first 12-lead electrocardiogram after return of spontaneous circulation were collected. The primary outcome was 30-day mortality.

Results

A number of electrocardiographic findings were significantly associated with 30-day mortality: atrial fibrillation/flutter (HR 2.29 [95% CI 1.17–4.49, p = 0.015]), right bundle branch block (HR 2.23 [95% CI 1.14–4.56, p = 0.020]), bifascicular block (HR 2.51 [95% CI 1.04–6.059, p = 0.040]), T inversion (HR 2.01 [95% CI 1.02–3.99, p = 0.043]), QTc duration ≥500 ms (HR 2.21 [95% CI 1.10–4.42, p = 0.025]) and QT dispersion ≥ 100 ms (HR 2.11 [95% CI 1.02–4.37, p = 0.045]).

Conclusion

Several different electrocardiographic findings are associated with increased mortality in patients with OHCA due to MI.

查看原文本刊更多论文

院外心脏骤停30天结局：成功复苏后第一次心电图的重要性。

背景：虽然有大量证据表明院前复苏对院外心脏骤停（OHCA）后存活的影响，但对自然循环恢复后首次心电图的重要性的研究却少得多。目的：本研究的目的是确定心肌梗死（MI） OHCA患者预后相关的心电图表现。方法：回顾性分析119例心肌梗死致OHCA患者的临床资料。收集患者特征及自主循环恢复后首次12导联心电图。主要终点为30天死亡率。结果:许多心电图描记的发现与30天死亡率显著相关:心房颤动/颤振(HR 2.29 (95% CI 1.17 - -4.49, p = 0.015)),右束支块(HR 2.23 (95% CI 1.14 - -4.56, p = 0.020)), bifascicular块(HR 2.51 (95% CI 1.04 - -6.059, p = 0.040)), T反演(HR 2.01 (95% CI 1.02 - -3.99, p = 0.043)), QTc时间≥500 ms (HR 2.21 (95% CI 1.10 - -4.42, p = 0.025))和QT离散≥100 ms (HR 2.11 (95% CI 1.02 - -4.37, p = 0.045))。结论：几种不同的心电图结果与心肌梗死引起的OHCA患者死亡率增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Emergency Medicine 医学-急救医学

CiteScore

2.40

自引率

6.70%

发文量

339

审稿时长

2-4 weeks

期刊介绍： The Journal of Emergency Medicine is an international, peer-reviewed publication featuring original contributions of interest to both the academic and practicing emergency physician. JEM, published monthly, contains research papers and clinical studies as well as articles focusing on the training of emergency physicians and on the practice of emergency medicine. The Journal features the following sections: • Original Contributions • Clinical Communications: Pediatric, Adult, OB/GYN • Selected Topics: Toxicology, Prehospital Care, The Difficult Airway, Aeromedical Emergencies, Disaster Medicine, Cardiology Commentary, Emergency Radiology, Critical Care, Sports Medicine, Wound Care • Techniques and Procedures • Technical Tips • Clinical Laboratory in Emergency Medicine • Pharmacology in Emergency Medicine • Case Presentations of the Harvard Emergency Medicine Residency • Visual Diagnosis in Emergency Medicine • Medical Classics • Emergency Forum • Editorial(s) • Letters to the Editor • Education • Administration of Emergency Medicine • International Emergency Medicine • Computers in Emergency Medicine • Violence: Recognition, Management, and Prevention • Ethics • Humanities and Medicine • American Academy of Emergency Medicine • AAEM Medical Student Forum • Book and Other Media Reviews • Calendar of Events • Abstracts • Trauma Reports • Ultrasound in Emergency Medicine