Predictors of neurologically favorable survival among patients with out-of-hospital cardiac arrest: A tertiary referral hospital experience

Despite recent advances in medical support and interventions, only 5% to 10% of patients with out-of-hospital cardiac arrest (OHCA) survive to discharge. In this study, factors related to neurologically favorable survival in patients with OHCA were analyzed.A total of 129 patients who were admitted to hospital with OHCA were retrospectively enrolled.Sustained return of spontaneous circulation (ROSC) (ROSC lasting >20 min) was achieved in 29 (22.4%) patients. Percentage of cardiac arrests with ischemic etiology was significantly higher in successful ROSC group (p<0.001). In multivariate logistic regression analysis, cardiac arrest with ischemic etiology (p=0.004) and cardiopulmonary resuscitation (CPR) duration (p=0.013) were found to be independent predictors for ROSC. One-minute increment in CPR duration was associated with 1.202-fold increase in failure to achieve ROSC. Among patients with ROSC, 7 (5.4%) survived to hospital discharge, and 1-minute increment in CPR duration was associated with a 1.123-fold decrease in neurologically favorable survival (p=0.005).In patients with OHCA, ischemic etiology is associated with better ROSC rate compared to other reasons for cardiac arrest, and patients with prolonged CPR are less likely to survive.