Improving Post-Cardiac Arrest Outcome

Heart attack patients more likely to survive when illness severity ranked

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Following cardiac arrest, one patient may recover quickly while another struggles with lingering symptoms. But interestingly enough, classifying patients might help improve patient outcomes — regardless of illness severity.

Researchers at the University of Pittsburgh School of Medicine suggest that scoring the severity of a patient's illness after cardiac arrest can aid with recovery.

"Ask your doctor if you might be at risk for cardiac arrest."

Jon C. Rittenberger, M.D., lead author and assistant professor of emergency medicine for the University of Pittsburgh School of Medicine, said that about 10 percent of the time, information such as initial heart rhythm or whether there was a witness to the collapse, is unavailable. Lack of this information makes it difficult for doctors to classify patients, customize treatments or counsel families about the prognosis.

In turn, investigators examined data for more than 450 cardiac arrest patients following treatment at UPMC Presbyterian, which is affiliated with the University of Pittsburgh School of Medicine.

Dr. Rittenberger said the research team found that classifying patients by illness severity created better survival odds and outcomes than historically relied upon factors such as heart rhythm at the time of cardiac arrest or where it occurred. Patients across all groups, even the most severe, fared better through this method.

They reviewed treatment records between January 2005 and December 2009, and included cardiac arrests that occurred both in and out of the hospital. In North America, cardiac arrest in the most common cause of death, and about 350,000 die as a result of it each year.

They took into account that in 2007 the hospital added a post-cardiac arrest care plan, which included therapeutic hypothermia — a type of cooling to minimize brain damage.

Researchers identified four distinct categories of illness severity based on neurological and cardiopulmonary dysfunction during the initial hours following restoration of a patient’s circulation. They examined survival rates, neurological outcomes and multiple organ failure for those in each group and found significant variations among groups.

The research was published in journal Resuscitation.

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Review Date: 
July 16, 2011
Last Updated:
July 21, 2011