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In-Hospital and One-Year Outcomes of Patients after Early and Late Resuscitated Cardiac Arrest Complicating Acute Myocardial Infarction-Data from a Nationwide Database. J Clin Med 2022; 11:jcm11030609. [PMID: 35160061 PMCID: PMC8836754 DOI: 10.3390/jcm11030609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 02/04/2023] Open
Abstract
The prognostic role of early (less than 48 h) resuscitated cardiac arrest (ErCA) complicating acute myocardial infarction (AMI) is still controversial. The present study aimed to analyse the short-term and one-year outcomes of patients after ErCA and late resuscitated cardiac arrest (LrCA) compared to patients without cardiac arrest (CA) complicating AMI. Data from the prospective nationwide Polish Registry of Acute Coronary Syndromes (PL-ACS) were used to assess patients with resuscitated cardiac arrest (rCA) after AMI. Baseline clinical characteristics and the predictors of all-cause death were assessed. The all-cause mortality rate, complications, performed procedures, and re-hospitalisations were assessed for the in-hospital period, 30 days after discharge, and 6- and 12-month follow-ups. Among 167,621 cases of AMI, CA occurred in 3564 (2.1%) patients, that is, 3100 (87%) and 464 (13%) patients with ErCA and LrCA, respectively. The mortality rates in the ErCA vs. LrCA and CA vs. non-CA groups were as follows: in-hospital: 32.1% vs. 59.1% (p < 0.0001) and 35.6% vs. 6.0% (p < 0.0001); 30-day: 2.2% vs. 3.2% (p = 0.42) and 9.9% vs. 5.2% (p < 0.0001); 6-month: 9.2% vs. 17.9% (p = 0.0001) and 12.3% vs. 21.1% (p < 0.0001); and 12-month: 12.3% vs. 21.1% (p = 0.001) and 13% vs. 7.7% (p < 0.0001), respectively. ErCA (hazard ratio (HR): 1.54, confidence interval (CI):1.28–1.89; p < 0.0001) and LrCA (HR: 2.34, CI: 1.39–3.93; p = 0.001) increased the risk of 12-month mortality. During the 12-month follow-up, patients after LrCA more frequently required hospitalisation due to heart failure compared to patients after ErCA. ErCA was related to a higher hospitalisation rate due to coronary-related causes and a higher rate of percutaneous coronary intervention. An episode of LrCA was associated with higher in-hospital and long-term mortality compared to ErCA. ErCA and LrCA were independent risk factors for one-year mortality.
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Mathiesen C, McPherson D, Ordway C, Smith M. Caring for Patients Treated With Therapeutic Hypothermia. Crit Care Nurse 2017; 35:e1-e12. [PMID: 26427982 DOI: 10.4037/ccn2015168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Numerous studies have indicated that therapeutic hypothermia can improve neurological outcomes after cardiac arrest. This treatment has redefined care after resuscitation and offers an aggressive intervention that may mitigate postresuscitation syndrome. Caregivers at Lehigh Valley Health Network, Allentown, Pennsylvania, an academic, community Magnet hospital, treated more than 200 patients with therapeutic hypothermia during an 8-year period. An interprofessional team within the hospital developed, implemented, and refined a clinical practice guideline for therapeutic hypothermia. In their experience, beyond a protocol, 5 critical elements of success (interprofessional stakeholders, coordination of care delivery, education, interprofessional case analysis, and participation in a global database) enhanced translation into clinical practice.
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Affiliation(s)
- Claranne Mathiesen
- Claranne Mathiesen is the director, medical operations, neuroscience service line, at Lehigh Valley Health Network, Allentown, Pennsylvania.Denise McPherson was director of the cardiac intensive care unit at Lehigh Valley Health Network when this article was written. That unit cares for patients undergoing therapeutic hypothermia after cardiac arrest.Carolyn Ordway is the patient care specialist, cardiac intensive care unit, at Lehigh Valley Health Network.Maureen Smith is the patient care specialist, neuroscience intensive care unit, at Lehigh Valley Health Network.
| | - Denise McPherson
- Claranne Mathiesen is the director, medical operations, neuroscience service line, at Lehigh Valley Health Network, Allentown, Pennsylvania.Denise McPherson was director of the cardiac intensive care unit at Lehigh Valley Health Network when this article was written. That unit cares for patients undergoing therapeutic hypothermia after cardiac arrest.Carolyn Ordway is the patient care specialist, cardiac intensive care unit, at Lehigh Valley Health Network.Maureen Smith is the patient care specialist, neuroscience intensive care unit, at Lehigh Valley Health Network
| | - Carolyn Ordway
- Claranne Mathiesen is the director, medical operations, neuroscience service line, at Lehigh Valley Health Network, Allentown, Pennsylvania.Denise McPherson was director of the cardiac intensive care unit at Lehigh Valley Health Network when this article was written. That unit cares for patients undergoing therapeutic hypothermia after cardiac arrest.Carolyn Ordway is the patient care specialist, cardiac intensive care unit, at Lehigh Valley Health Network.Maureen Smith is the patient care specialist, neuroscience intensive care unit, at Lehigh Valley Health Network
| | - Maureen Smith
- Claranne Mathiesen is the director, medical operations, neuroscience service line, at Lehigh Valley Health Network, Allentown, Pennsylvania.Denise McPherson was director of the cardiac intensive care unit at Lehigh Valley Health Network when this article was written. That unit cares for patients undergoing therapeutic hypothermia after cardiac arrest.Carolyn Ordway is the patient care specialist, cardiac intensive care unit, at Lehigh Valley Health Network.Maureen Smith is the patient care specialist, neuroscience intensive care unit, at Lehigh Valley Health Network
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Approaches for Therapeutic Temperature Management. JOURNAL OF INFUSION NURSING 2016; 39:26-9. [DOI: 10.1097/nan.0000000000000146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Casella G, Carinci V, Cavallo P, Guastaroba P, Pavesi PC, Pallotti MG, Sangiorgio P, Barbato G, Coniglio C, Iarussi B, Gordini G, Di Pasquale G. Combining therapeutic hypothermia and emergent coronary angiography in out-of-hospital cardiac arrest survivors: Optimal post-arrest care for the best patient. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2014; 4:579-88. [DOI: 10.1177/2048872614564080] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2014] [Accepted: 11/23/2014] [Indexed: 11/15/2022]
Affiliation(s)
- Gianni Casella
- Department of Cardiology, Maggiore Hospital, Bologna, Italy
| | | | | | - Paolo Guastaroba
- Regional Health Care Agency, Regione Emilia-Romagna, Bologna, Italy
| | - Pier C Pavesi
- Department of Cardiology, Maggiore Hospital, Bologna, Italy
| | | | | | | | - Carlo Coniglio
- Intensive Care Unit/118 EMS, Maggiore Hospital, Bologna, Italy
| | - Bruno Iarussi
- Intensive Care Unit/118 EMS, Maggiore Hospital, Bologna, Italy
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Long-Tounsel R, Wilson J, Adams C, Reising DL. Urban and Suburban Hospital System Implementation of Multipoint Access Targeted Temperature Management in Postcardiac Arrest Patients. Ther Hypothermia Temp Manag 2014. [DOI: 10.1089/ther.2013.0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ruby Long-Tounsel
- Department of Emergency Medicine, Methodist Hospitals, Gary, Indiana
| | - Jessica Wilson
- Department of Nursing Development, Methodist Hospitals, Gary, Indiana
| | - Constance Adams
- Department of Cardiovascular Care, Methodist Hospitals, Gary, Indiana
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