Journal article
Twenty-year trends in the characteristic, management and outcome of patients with ST-elevation myocardial infarction and out-of-hospital reanimation. Insight from the national AMIS PLUS registry 1997-2017.
- Müller A Department of Medical Intensive Care, University Hospital Zurich, Switzerland. Electronic address: andrea.mueller@usz.ch.
- Maggiorini M Department of Medical Intensive Care, University Hospital Zurich, Switzerland.
- Radovanovic D AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland.
- Erne P AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Switzerland.
- 2018-11-18
Published in:
- Resuscitation. - 2019
Cardiogenic shock
Characteristic
Insight from the national AMIS PLUS registry
Management
Myocardial infraction
Out-of hospital resuscitated patients with ST-elevation
Outcome
Aged
Cardiopulmonary Resuscitation
Case-Control Studies
Female
Hospital Mortality
Humans
Hypothermia, Induced
Male
Middle Aged
Out-of-Hospital Cardiac Arrest
Percutaneous Coronary Intervention
Prospective Studies
Registries
ST Elevation Myocardial Infarction
Shock, Cardiogenic
Switzerland
Time-to-Treatment
Treatment Outcome
English
BACKGROUND
Few studies describe recent changes in the incidence, treatment and outcome of successfully resuscitated STEMI patients after out-of-hospital cardiac arrest (OHCA) compared with non-OHCA STEMI patients.
OBJECTIVE
To examine temporal trends in the incidence, therapeutic management, most serious complications, mortality rate and outcome of OHCA patients fulfilling criteria of STEMI compared with a reference group of STEMI patients without OHCA.
METHODS
Analysis of registry data (AMIS Plus Registry) among STEMI patients both with and without OHCA between 1997 and 2017.
RESULTS
Among 31,650 patients with STEMI, 6.8% were successfully resuscitated prior to hospital admission. Increasing incidences of hospital-admitted patients following successful out-of-hospital CPR were observed (4.5% in 1999 vs. 8.6% in 2017). OHCA STEMI patients were at higher clinical risk at presentation (36.1% vs. 2.7%; p < 0.001 with cardiogenic shock) despite a shorter time span from the onset of symptoms to hospitalization (195 min vs. 107 min; p < 0.001) and a lower prevalence of cardiovascular risk factors except smoking. More PCIs were performed in STEMI patients with OHCA (78.9% vs. 74.5% for non-OHCA patients; p < 0.001). However, over time PCI became the preferred primary intervention irrespective of the OHCA status of STEMI patients. For STEMI patients without OHCA, there was a significant correlation between PCI and time periods on in-hospital mortality (p < 0.001), which was p = 0.002 when adjusted for age and gender. For STEMI patients with OHCA, the interaction between PCI and time was unadjusted p = 0.395 and p = 0.438 when adjusted for age and gender.
Few studies describe recent changes in the incidence, treatment and outcome of successfully resuscitated STEMI patients after out-of-hospital cardiac arrest (OHCA) compared with non-OHCA STEMI patients.
OBJECTIVE
To examine temporal trends in the incidence, therapeutic management, most serious complications, mortality rate and outcome of OHCA patients fulfilling criteria of STEMI compared with a reference group of STEMI patients without OHCA.
METHODS
Analysis of registry data (AMIS Plus Registry) among STEMI patients both with and without OHCA between 1997 and 2017.
RESULTS
Among 31,650 patients with STEMI, 6.8% were successfully resuscitated prior to hospital admission. Increasing incidences of hospital-admitted patients following successful out-of-hospital CPR were observed (4.5% in 1999 vs. 8.6% in 2017). OHCA STEMI patients were at higher clinical risk at presentation (36.1% vs. 2.7%; p < 0.001 with cardiogenic shock) despite a shorter time span from the onset of symptoms to hospitalization (195 min vs. 107 min; p < 0.001) and a lower prevalence of cardiovascular risk factors except smoking. More PCIs were performed in STEMI patients with OHCA (78.9% vs. 74.5% for non-OHCA patients; p < 0.001). However, over time PCI became the preferred primary intervention irrespective of the OHCA status of STEMI patients. For STEMI patients without OHCA, there was a significant correlation between PCI and time periods on in-hospital mortality (p < 0.001), which was p = 0.002 when adjusted for age and gender. For STEMI patients with OHCA, the interaction between PCI and time was unadjusted p = 0.395 and p = 0.438 when adjusted for age and gender.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.resuscitation.2018.11.010
- PMID 30447263
- Persistent URL
- https://sonar.ch/global/documents/191487
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