Cardiac arrest: Death and further arrests were common in patients who survived to be discharged.

Clinical bottom line (level 4)

  1. A tenth of patient who had a cardiac arrest out of hospital survived to discharge.
  2. A seventh had a further cardiac arrest in the next year.
  3. One third of the working population returned to work within 1 year.
  4. Over half were dead within 5 years.
Reid Graves et al: Resuscitation 1997; 35: 117-121
Expires October 2003

The study

Retrospective cohort study with objective outcomes, not adjusted for confounding factors, not validated in an independent set of patients.

Setting: city, Sweden

324 patients (aged 0 to 89; mean 64, 79% male) who had a cardiac arrest out of hospital and survived to be discharged
Patients were resuscitated using advanced life support protocols.

?100% followed for
Outcomes studied:
  • death at 1 year
  • death at 5 years
  • death at 10 years
  • further cardiac arrest
  • returned to work

    • The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)    		 NNF
    (95% CI)
    death 12 months 61/324 18.8%
    (14.6% to 23.1%)    		 5
    (4 to 7)
    death 5 years 78/324 24.1%
    (19.4% to 28.7%)    		 4
    (3 to 5)
    death 10 years 266/324 82.1%
    (77.9% to 86.3%)    		 1
    (1 to 1)
    further cardiac arrest 12 months 46/324 14.2%
    (10.4% to 18.0%)    		 7
    (6 to 10)
    returned to work 12 months 35/102 34.3%
    (25.1% to 43.5%)    		 3
    (2 to 4)

    Comments

    1. Time to defibrillation was a startlingly good 6 mins, in addition to good community awareness of basic life support.
    2. 9% of patients with an out of hospital cardiac arrest were discharged alive

    Citation

    1. Reid Graves J, Herlitz J, Bang A, et al: Survivors of out of hospital cardiac arrest: their prognosis, longevity and functional status. Resuscitation 1997; 35: 117-121
    Contributor: Chris Ball and Musab Hayatli, October 1999
    Reviewer: Luis Ruiz Del Fresno

    Clinical Question.
    Patient cardiac arrest out of hospital
    Intervention or Exposure discharged alive
    Outcome survival