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Title: Two-year survival and neurological outcome of in-hospital cardiac arrest patients rescued by extracorporeal cardiopulmonary resuscitation.
Author: Shin TG, Jo IJ, Sim MS, Song YB, Yang JH, Hahn JY, Choi SH, Gwon HC, Jeon ES, Sung K, Lee YT, Choi JH.
Journal: Int J Cardiol; 2013 Oct 09; 168(4):3424-30. PubMed ID: 23664696.
Abstract:
BACKGROUND: The clinical benefit of extracorporeal cardiopulmonary resuscitation (E-CPR) has been proved in short-term follow-up studies. However, the benefit of E-CPR beyond 1 year has been not known. We investigated 2-year outcome of patients who received E-CPR or conventional CPR (C-CPR). METHODS: We analyzed a total of 406 adult in-hospital cardiac arrest victims who underwent CPR for more than 10 min from 2003 to 2009. The two-year survival and neurological outcome of E-CPR (n=85) and C-CPR (n=321) were compared using propensity score-matched analysis. RESULTS: The 2-year survival with minimal neurological impairment was 4-fold higher in the E-CPR group than the C-CPR group (23.5% versus 5.9%, hazard ratio (HR)=0.57, 95% confidence interval (CI)=0.43-0.75, p<0.001) by unadjusted analysis. After propensity-score matching, it was still 4-fold higher in the E-CPR group than the C-CPR group (20.0% versus 5.0%, HR=0.53, 95% CI=0.36-0.80, p=0.002). In the E-CPR group, the independent predictors associated with minimal neurological impairment were age ≤65 years (HR=0.46; 95% CI=0.26-0.81; p=0.008), CPR duration ≤35 min (HR=0.37; 95% CI=0.18-0.76; p=0.007), and subsequent cardiovascular intervention including coronary intervention or cardiac surgery (HR=0.36; 95% CI=0.18-0.68; p=0.002). CONCLUSIONS: The initial survival benefit of E-CPR for cardiac arrest patients persisted at 2 years.

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