Two-year survival and neurological outcome of in-hospital cardiac arrest patients rescued by extracorporeal cardiopulmonary resuscitation☆

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 1year 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 10min 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 p =0.002). In the E-CPR group, the independent predictors associated with minimal neurological impairment were age ≤65years (HR=0.46; 95% CI=0.26–0.81; p =0.008), CPR duration ≤35min (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 2years.