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Pulmonary Embolism Related Sudden Cardiac Arrest Admitted Alive at Hospital: Management and Outcomes.
Resuscitation. 2017 Apr 18;:
Authors: Bougouin W, Marijon E, Planquette B, Karam N, Dumas F, Celermajer DS, Jost D, Lamhaut L, Beganton F, Cariou A, Meyer G, Jouven X, on behalf from the Sudden Death Expertise Center
Abstract
AIM: Pulmonary Embolism (PE) is a relatively common cardiovascular condition, occasionally and tragically manifesting as Sudden Cardiac Arrest (SCA). The natural history of SCA complicating PE has been poorly evaluated.In this study, we described the management and outcome of PE-related SCA.
METHODS: In this prospective population-based study, we included all patients admitted at hospital alive after out-of- hospital SCA, in Paris and suburbs, France (6.6 million inhabits), from May 2011 to September 2015.
RESULTS: Of 2,926 patients hospitalized after SCA, 82 cases were diagnosed as PE-related SCA (2.8%, 95%CI=2.2-3.4). Systemic thrombolysis was performed in 47 patients (57%), without significant increased risk of major bleeding among patients treated with thrombolysis. 12 patients (15%) were treated with ECLS, 29 patients (36%) had targeted temperature management, and 20 patients (24%) underwent coronary angiography. 94% of PE-related SCA had initial non-shockable rhythm, and were associated with better survival compared with other non-shockable SCA (crude OR=3.0, 95%CI=1.7-5.4, P <0.001; adjusted OR=4.1, 95%CI 2.0-8.3, P<0.001). Among PE-related SCA, thrombolysis was independently associated with successful outcomes (OR=12.5, 95%CI=1.8-89.1, P=0.01). Multiple sensitivity analysis were performed, with consistent results.
CONCLUSIONS: PE is responsible of approximately 3% of hospitalizations for SCA. Thrombolysis was associated with an increased survival in this population, reinforcing current guidelines advocating for such treatment in PE-related SCA.
PMID: 28432023 [PubMed - as supplied by publisher]