Long-term survival following out-of-hospital cardiac arrest

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: Although the factors associated with short-term survival from out-of-hospital cardiac arrest (OHCA) are well established, relatively little is known about the factors that influence long-term survival. In this study, we describe the 15-year survival outcomes of OHCA survivors and examine the influence of peri-arrest factors and 12-month outcomes on long-term survival. Methods: Survivors of OHCA between 2000 and 2014 identified from the Victorian Ambulance Cardiac Arrest Registry were linked with state-wide death records. Kaplan-Meier survival curves and Cox regression models were used to estimate long-term survival outcomes. Results: A total of 3449 patients were included with a mean survival duration of 11.9 (95% CI 11.7 to 12.1) years. The 1-year survival rate was 92.2% (95% CI 91.3% to 93.1%), while the 5, 10 and 15-year survival rates were 81.4% (95% CI 79.9% to 82.8%), 70.1% (95% CI 67.9% to 72.1%) and 62.3% (95% CI 58.9% to 65.5%), respectively. The standardised mortality rate of OHCA survivors was 5.6 times that of the standard Australian population in the first-year postarrest, but approached that of the standard population 5 years postarrest. Few peri-arrest factors were independently associated with long-term survival after discharge. Rather, transport to a percutaneous coronary intervention-capable hospital and discharge home from hospital were associated with longevity. Returning to work and favourable physical/functional recovery were associated with improved survival after 12 months. Conclusions: OHCA survivors experience relatively favourable long-term survival after discharge from hospital. While peri-arrest factors had little influence on long-term survival after hospital discharge, favourable recovery postdischarge was associated with improved long-term outcomes.

Original languageEnglish
Pages (from-to)1104-1110
Number of pages7
JournalHeart
Volume103
Issue number14
DOIs
Publication statusPublished - 1 Jul 2017

Keywords

  • Cardiac arrest
  • Cardiac arrhythmias and resuscitation science
  • Epidemiology
  • Quality and outcomes of care

Cite this

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title = "Long-term survival following out-of-hospital cardiac arrest",
abstract = "Objective: Although the factors associated with short-term survival from out-of-hospital cardiac arrest (OHCA) are well established, relatively little is known about the factors that influence long-term survival. In this study, we describe the 15-year survival outcomes of OHCA survivors and examine the influence of peri-arrest factors and 12-month outcomes on long-term survival. Methods: Survivors of OHCA between 2000 and 2014 identified from the Victorian Ambulance Cardiac Arrest Registry were linked with state-wide death records. Kaplan-Meier survival curves and Cox regression models were used to estimate long-term survival outcomes. Results: A total of 3449 patients were included with a mean survival duration of 11.9 (95{\%} CI 11.7 to 12.1) years. The 1-year survival rate was 92.2{\%} (95{\%} CI 91.3{\%} to 93.1{\%}), while the 5, 10 and 15-year survival rates were 81.4{\%} (95{\%} CI 79.9{\%} to 82.8{\%}), 70.1{\%} (95{\%} CI 67.9{\%} to 72.1{\%}) and 62.3{\%} (95{\%} CI 58.9{\%} to 65.5{\%}), respectively. The standardised mortality rate of OHCA survivors was 5.6 times that of the standard Australian population in the first-year postarrest, but approached that of the standard population 5 years postarrest. Few peri-arrest factors were independently associated with long-term survival after discharge. Rather, transport to a percutaneous coronary intervention-capable hospital and discharge home from hospital were associated with longevity. Returning to work and favourable physical/functional recovery were associated with improved survival after 12 months. Conclusions: OHCA survivors experience relatively favourable long-term survival after discharge from hospital. While peri-arrest factors had little influence on long-term survival after hospital discharge, favourable recovery postdischarge was associated with improved long-term outcomes.",
keywords = "Cardiac arrest, Cardiac arrhythmias and resuscitation science, Epidemiology, Quality and outcomes of care",
author = "Emily Andrew and Ziad Nehme and Rory Wolfe and Stephen Bernard and Smith, {Karen Louise}",
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Long-term survival following out-of-hospital cardiac arrest. / Andrew, Emily ; Nehme, Ziad; Wolfe, Rory; Bernard, Stephen; Smith, Karen Louise.

In: Heart, Vol. 103, No. 14, 01.07.2017, p. 1104-1110.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Long-term survival following out-of-hospital cardiac arrest

AU - Andrew, Emily

AU - Nehme, Ziad

AU - Wolfe, Rory

AU - Bernard, Stephen

AU - Smith, Karen Louise

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Objective: Although the factors associated with short-term survival from out-of-hospital cardiac arrest (OHCA) are well established, relatively little is known about the factors that influence long-term survival. In this study, we describe the 15-year survival outcomes of OHCA survivors and examine the influence of peri-arrest factors and 12-month outcomes on long-term survival. Methods: Survivors of OHCA between 2000 and 2014 identified from the Victorian Ambulance Cardiac Arrest Registry were linked with state-wide death records. Kaplan-Meier survival curves and Cox regression models were used to estimate long-term survival outcomes. Results: A total of 3449 patients were included with a mean survival duration of 11.9 (95% CI 11.7 to 12.1) years. The 1-year survival rate was 92.2% (95% CI 91.3% to 93.1%), while the 5, 10 and 15-year survival rates were 81.4% (95% CI 79.9% to 82.8%), 70.1% (95% CI 67.9% to 72.1%) and 62.3% (95% CI 58.9% to 65.5%), respectively. The standardised mortality rate of OHCA survivors was 5.6 times that of the standard Australian population in the first-year postarrest, but approached that of the standard population 5 years postarrest. Few peri-arrest factors were independently associated with long-term survival after discharge. Rather, transport to a percutaneous coronary intervention-capable hospital and discharge home from hospital were associated with longevity. Returning to work and favourable physical/functional recovery were associated with improved survival after 12 months. Conclusions: OHCA survivors experience relatively favourable long-term survival after discharge from hospital. While peri-arrest factors had little influence on long-term survival after hospital discharge, favourable recovery postdischarge was associated with improved long-term outcomes.

AB - Objective: Although the factors associated with short-term survival from out-of-hospital cardiac arrest (OHCA) are well established, relatively little is known about the factors that influence long-term survival. In this study, we describe the 15-year survival outcomes of OHCA survivors and examine the influence of peri-arrest factors and 12-month outcomes on long-term survival. Methods: Survivors of OHCA between 2000 and 2014 identified from the Victorian Ambulance Cardiac Arrest Registry were linked with state-wide death records. Kaplan-Meier survival curves and Cox regression models were used to estimate long-term survival outcomes. Results: A total of 3449 patients were included with a mean survival duration of 11.9 (95% CI 11.7 to 12.1) years. The 1-year survival rate was 92.2% (95% CI 91.3% to 93.1%), while the 5, 10 and 15-year survival rates were 81.4% (95% CI 79.9% to 82.8%), 70.1% (95% CI 67.9% to 72.1%) and 62.3% (95% CI 58.9% to 65.5%), respectively. The standardised mortality rate of OHCA survivors was 5.6 times that of the standard Australian population in the first-year postarrest, but approached that of the standard population 5 years postarrest. Few peri-arrest factors were independently associated with long-term survival after discharge. Rather, transport to a percutaneous coronary intervention-capable hospital and discharge home from hospital were associated with longevity. Returning to work and favourable physical/functional recovery were associated with improved survival after 12 months. Conclusions: OHCA survivors experience relatively favourable long-term survival after discharge from hospital. While peri-arrest factors had little influence on long-term survival after hospital discharge, favourable recovery postdischarge was associated with improved long-term outcomes.

KW - Cardiac arrest

KW - Cardiac arrhythmias and resuscitation science

KW - Epidemiology

KW - Quality and outcomes of care

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U2 - 10.1136/heartjnl-2016-310485

DO - 10.1136/heartjnl-2016-310485

M3 - Article

VL - 103

SP - 1104

EP - 1110

JO - Heart

JF - Heart

SN - 1355-6037

IS - 14

ER -