The association between systolic blood pressure on arrival at hospital and outcome in adults surviving from out-of-hospital cardiac arrests of presumed cardiac aetiology

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Abstract

Background: The optimal blood pressure target following successful resuscitation from out-of-hospital cardiac arrest (OHCA) is uncertain. This study aimed to explore the association between level of systolic blood pressure (SBP) on arrival at hospital and survival to hospital discharge. Methods: We analysed eligible OHCAs occurring between January 2003 and December 2011 from the Victorian Ambulance Cardiac Arrest Register (VACAR). Inclusion criteria were: adults (=18 years), presumed cardiac aetiology, not paramedic witnessed, and ROSC at hospital arrival. Multivariate logistic regression models were performed by initial rhythm (shockable/non-shockable) to examine the relationship between SBP at hospital arrival in 10 mmHg increments and survival to hospital discharge. Models were adjusted for known predictors of survival, including duration of arrest. Results: Of 3620 eligible cases, 14 were hypotensive (SBP <90 mmHg) on hospital arrival (10 shockable and 19 non-shockable). For patients in shockable rhythms, discharge survival was maximal at 120-129 mmHg (54 ), and in the adjusted model (=120 mmHg as reference) SBP decrements below 90 mmHg were associated with lower survival: 80-89 mmHg AOR = 0.49 (95 CI: 0.24-0.95);
Original languageEnglish
Pages (from-to)509 - 515
Number of pages7
JournalResuscitation
Volume85
Issue number4
DOIs
Publication statusPublished - 2014

Cite this

@article{e6c4dae98d3c4190a99dc4bd2375fc99,
title = "The association between systolic blood pressure on arrival at hospital and outcome in adults surviving from out-of-hospital cardiac arrests of presumed cardiac aetiology",
abstract = "Background: The optimal blood pressure target following successful resuscitation from out-of-hospital cardiac arrest (OHCA) is uncertain. This study aimed to explore the association between level of systolic blood pressure (SBP) on arrival at hospital and survival to hospital discharge. Methods: We analysed eligible OHCAs occurring between January 2003 and December 2011 from the Victorian Ambulance Cardiac Arrest Register (VACAR). Inclusion criteria were: adults (=18 years), presumed cardiac aetiology, not paramedic witnessed, and ROSC at hospital arrival. Multivariate logistic regression models were performed by initial rhythm (shockable/non-shockable) to examine the relationship between SBP at hospital arrival in 10 mmHg increments and survival to hospital discharge. Models were adjusted for known predictors of survival, including duration of arrest. Results: Of 3620 eligible cases, 14 were hypotensive (SBP <90 mmHg) on hospital arrival (10 shockable and 19 non-shockable). For patients in shockable rhythms, discharge survival was maximal at 120-129 mmHg (54 ), and in the adjusted model (=120 mmHg as reference) SBP decrements below 90 mmHg were associated with lower survival: 80-89 mmHg AOR = 0.49 (95 CI: 0.24-0.95);",
author = "Bray, {Janet Elizabeth} and Bernard, {Stephen Anthony} and Kate Cantwell and Stephenson, {Michael William} and Smith, {Karen Louise}",
year = "2014",
doi = "10.1016/j.resuscitation.2013.12.005",
language = "English",
volume = "85",
pages = "509 -- 515",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier",
number = "4",

}

TY - JOUR

T1 - The association between systolic blood pressure on arrival at hospital and outcome in adults surviving from out-of-hospital cardiac arrests of presumed cardiac aetiology

AU - Bray, Janet Elizabeth

AU - Bernard, Stephen Anthony

AU - Cantwell, Kate

AU - Stephenson, Michael William

AU - Smith, Karen Louise

PY - 2014

Y1 - 2014

N2 - Background: The optimal blood pressure target following successful resuscitation from out-of-hospital cardiac arrest (OHCA) is uncertain. This study aimed to explore the association between level of systolic blood pressure (SBP) on arrival at hospital and survival to hospital discharge. Methods: We analysed eligible OHCAs occurring between January 2003 and December 2011 from the Victorian Ambulance Cardiac Arrest Register (VACAR). Inclusion criteria were: adults (=18 years), presumed cardiac aetiology, not paramedic witnessed, and ROSC at hospital arrival. Multivariate logistic regression models were performed by initial rhythm (shockable/non-shockable) to examine the relationship between SBP at hospital arrival in 10 mmHg increments and survival to hospital discharge. Models were adjusted for known predictors of survival, including duration of arrest. Results: Of 3620 eligible cases, 14 were hypotensive (SBP <90 mmHg) on hospital arrival (10 shockable and 19 non-shockable). For patients in shockable rhythms, discharge survival was maximal at 120-129 mmHg (54 ), and in the adjusted model (=120 mmHg as reference) SBP decrements below 90 mmHg were associated with lower survival: 80-89 mmHg AOR = 0.49 (95 CI: 0.24-0.95);

AB - Background: The optimal blood pressure target following successful resuscitation from out-of-hospital cardiac arrest (OHCA) is uncertain. This study aimed to explore the association between level of systolic blood pressure (SBP) on arrival at hospital and survival to hospital discharge. Methods: We analysed eligible OHCAs occurring between January 2003 and December 2011 from the Victorian Ambulance Cardiac Arrest Register (VACAR). Inclusion criteria were: adults (=18 years), presumed cardiac aetiology, not paramedic witnessed, and ROSC at hospital arrival. Multivariate logistic regression models were performed by initial rhythm (shockable/non-shockable) to examine the relationship between SBP at hospital arrival in 10 mmHg increments and survival to hospital discharge. Models were adjusted for known predictors of survival, including duration of arrest. Results: Of 3620 eligible cases, 14 were hypotensive (SBP <90 mmHg) on hospital arrival (10 shockable and 19 non-shockable). For patients in shockable rhythms, discharge survival was maximal at 120-129 mmHg (54 ), and in the adjusted model (=120 mmHg as reference) SBP decrements below 90 mmHg were associated with lower survival: 80-89 mmHg AOR = 0.49 (95 CI: 0.24-0.95);

UR - http://www.sciencedirect.com/science/article/pii/S0300957213008976

U2 - 10.1016/j.resuscitation.2013.12.005

DO - 10.1016/j.resuscitation.2013.12.005

M3 - Article

VL - 85

SP - 509

EP - 515

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

IS - 4

ER -