Significance of Hypotension after Return of Spontaneous Circulation from Out of Hospital Cardiac Arrest.
- Author:
Youngsun PARK
1
;
Sangsik CHOI
;
Won Young KIM
;
Chang Hwan SOHN
;
Shin AN
;
Dong Woo SEO
;
Won KIM
;
Kyoung Soo LIM
Author Information
1. Department of Emergency Medicine, College of Medicine University of Ulsan, Asan Medical Center, Seoul, Korea. wonpia@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Heart arrest;
Resuscitation;
Hypotension
- MeSH:
Cohort Studies;
Emergencies;
Heart Arrest;
Humans;
Hypotension;
Logistic Models;
Out-of-Hospital Cardiac Arrest;
Prevalence;
Resuscitation;
Retrospective Studies;
Tertiary Care Centers
- From:Journal of the Korean Society of Emergency Medicine
2011;22(5):416-422
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Arterial hypotension after return of spontaneous circulation (ROSC) from out of hospital cardiac arrest (OHCA) occurs frequently. However, few studies have described post-ROSC hypotension and the relationship with outcome in OHCA. This study aimed to find the prevalence of post-ROSC hypotension and to determine whether post-ROSC hypotension predicts outcome in OHCA. METHODS: This was a retrospective cohort study of patients with ROSC (>20 minutes) after OHCA and who were admitted to the emergency department in a tertiary hospital from July, 2005 to June, 2009. Patients' baseline characteristics, presence of arterial hypotension (<90 mmHg), mortality, and neurologic outcome were evaluated. Mortality rates were compared and multivariate logistic regression was used to determine if post-ROSC hypotension independently predicted death. RESULTS: One hundred forty seven patients (93 males) were studied. Post-ROSC hypotension occurred in 108(73%) patients and was associated with significantly higher mortality compared to non-exposure (82% vs. 44% p<0.001). In multivariate logistic regression analysis, post-ROSC hypotension (OR 4.4 [95% CI]) and non-cardiogenic causes (OR 19.7 [95% CI]) were independent predictors of death. CONCLUSION: Post-ROSC hypotension is common and can be an independent predictor of death in OHCA.
