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Conference Paper: Predictors of favourable neurological outcomes in a territory-first extracorporeal cardiopulmonary resuscitation programme

TitlePredictors of favourable neurological outcomes in a territory-first extracorporeal cardiopulmonary resuscitation programme
Authors
Issue Date2021
PublisherHong Kong Academy of Medicine Press: Open Access Journals. The Journal's web site is located at http://www.hkmj.org/
Citation
26th Medical Research Conference, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, 16 January 2021. In Hong Kong Medical Journal, 2021, v. 27 n. 1, Suppl. 1, p. 36, abstract no. 57 How to Cite?
AbstractBackground: Extracorporeal cardiopulmonary resuscitation (E-CPR) is an alternative resuscitation method that has been associated with better survival and neurological outcomes in both in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) compared with conventional cardiopulmonary resuscitation (CPR). This study aimed to report the results of the territory-first E-CPR programme at Queen Mary Hospital, and identify factors that predict favourable patient outcomes. Methods: This is a single centre, retrospective analysis of all patients who had OHCA or IHCA and were managed with E-CPR from 2012 to 2020. The outcome measures were survival with good neurological outcome, defined as Cerebral Performance Categories 1 or 2 at 3 months, and 30-day survival. Results: From 2012 to 2020, a total of 102 patients received E-CPR: 48 (47.1%) were patients who had OHCA, and 54 (52.9%) from IHCA. 63 (61.8%) patients were diagnosed with myocardial infarction, and 11 (10.8%) were diagnosed with acute myocarditis. The overall hospital survival was 24.5% (n=25), while intensive care unit survival was 31.4% (n=32). 19 (18.6%) patients survived with favourable neurological outcome. Having a shockable arrest rhythm at presentation was the strongest predictor of good neurological outcome in both univariate (P<0.001) and multivariate analysis (odds ratio=7.84; 95% confidence interval=1.63-37.60; P=0.010). Patients with good neurological outcome were also more likely to have received defibrillation during E-CPR (P=0.006), lower aspartate aminotransferase (AST) levels within 24 hours after E-CPR (P=0.003), myocardial infarction as the cause of cardiac arrest (P=0.026), and percutaneous coronary intervention (PCI) after E-CPR (P=0.007). Conclusion: Hong Kong’s first territory-wide E-CPR programme achieved a favourable survival with good neurological outcome of 18.6%, which is comparable to internationally reported outcomes. Patients who had a shockable rhythm at presentation, defibrillation during E-CPR, low AST values in the first 24 hours, myocardial infarction as the cause of cardiac arrest, or PCI after E-CPR had better neurological outcomes.
Persistent Identifierhttp://hdl.handle.net/10722/306553
ISSN
2023 Impact Factor: 3.1
2023 SCImago Journal Rankings: 0.261

 

DC FieldValueLanguage
dc.contributor.authorLi, ACC-
dc.contributor.authorFang, S-
dc.contributor.authorLin, JCR-
dc.contributor.authorIp, SWA-
dc.contributor.authorYeung, PNP-
dc.date.accessioned2021-10-22T07:36:16Z-
dc.date.available2021-10-22T07:36:16Z-
dc.date.issued2021-
dc.identifier.citation26th Medical Research Conference, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, 16 January 2021. In Hong Kong Medical Journal, 2021, v. 27 n. 1, Suppl. 1, p. 36, abstract no. 57-
dc.identifier.issn1024-2708-
dc.identifier.urihttp://hdl.handle.net/10722/306553-
dc.description.abstractBackground: Extracorporeal cardiopulmonary resuscitation (E-CPR) is an alternative resuscitation method that has been associated with better survival and neurological outcomes in both in-hospital cardiac arrest (IHCA) and out-of-hospital cardiac arrest (OHCA) compared with conventional cardiopulmonary resuscitation (CPR). This study aimed to report the results of the territory-first E-CPR programme at Queen Mary Hospital, and identify factors that predict favourable patient outcomes. Methods: This is a single centre, retrospective analysis of all patients who had OHCA or IHCA and were managed with E-CPR from 2012 to 2020. The outcome measures were survival with good neurological outcome, defined as Cerebral Performance Categories 1 or 2 at 3 months, and 30-day survival. Results: From 2012 to 2020, a total of 102 patients received E-CPR: 48 (47.1%) were patients who had OHCA, and 54 (52.9%) from IHCA. 63 (61.8%) patients were diagnosed with myocardial infarction, and 11 (10.8%) were diagnosed with acute myocarditis. The overall hospital survival was 24.5% (n=25), while intensive care unit survival was 31.4% (n=32). 19 (18.6%) patients survived with favourable neurological outcome. Having a shockable arrest rhythm at presentation was the strongest predictor of good neurological outcome in both univariate (P<0.001) and multivariate analysis (odds ratio=7.84; 95% confidence interval=1.63-37.60; P=0.010). Patients with good neurological outcome were also more likely to have received defibrillation during E-CPR (P=0.006), lower aspartate aminotransferase (AST) levels within 24 hours after E-CPR (P=0.003), myocardial infarction as the cause of cardiac arrest (P=0.026), and percutaneous coronary intervention (PCI) after E-CPR (P=0.007). Conclusion: Hong Kong’s first territory-wide E-CPR programme achieved a favourable survival with good neurological outcome of 18.6%, which is comparable to internationally reported outcomes. Patients who had a shockable rhythm at presentation, defibrillation during E-CPR, low AST values in the first 24 hours, myocardial infarction as the cause of cardiac arrest, or PCI after E-CPR had better neurological outcomes.-
dc.languageeng-
dc.publisherHong Kong Academy of Medicine Press: Open Access Journals. The Journal's web site is located at http://www.hkmj.org/-
dc.relation.ispartofHong Kong Medical Journal-
dc.relation.ispartof26th Medical Research Conference-
dc.titlePredictors of favourable neurological outcomes in a territory-first extracorporeal cardiopulmonary resuscitation programme-
dc.typeConference_Paper-
dc.identifier.emailIp, SWA: aaapril@hku.hk-
dc.identifier.emailYeung, PNP: pyeungng@hku.hk-
dc.identifier.authorityYeung, PNP=rp02517-
dc.description.natureabstract-
dc.identifier.hkuros328582-
dc.identifier.volume27-
dc.identifier.issue1, Suppl. 1-
dc.identifier.spage36, abstract no. 57-
dc.identifier.epage36, abstract no. 57-
dc.publisher.placeHong Kong-

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