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Citation
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Kim HJ, Kim GW, Oh SH, Park SH, Choi JH, Kim KH, Jeon WC, Lee HJ, Park KN. Am. J. Emerg. Med. 2014; 32(11): 1378-1381. |
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Affiliation
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Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. |
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Abstract
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INTRODUCTION: The aim of this study was to describe the epidemiology and outcomes of patients with therapeutic hypothermia after out-of-hospital cardiac arrest (OHCA) caused by self-inflicted intoxication.
METHODS: We performed a multicenter retrospective registry-based study of adult OHCA patients presenting to 24 hospitals over 6 years across South Korea. Data included demographics, resuscitation variables, postresuscitation variables, and self-inflicted intoxicants. Neurologic outcomes were categorized according to the Glasgow-Pittsburgh Cerebral Performance Categories (CPC) scale and were dichotomized as either good discharge outcomes (CPC 1 and 2) or poor discharge outcomes (CPC 3-5).
RESULTS: A total of 930 OHCA cases were identified, 24 (2.6%) of which were classified as cardiac arrest caused by acute intoxication. The mean age of cases was 57.2 ± 12.9 years. The mean time from collapse to return of spontaneous circulation was 35.4 ± 18.7 minutes. The presenting rhythm was pulseless electrical activity in 6 patients (25%) and asystole in 18 patients (75%). Eleven patients (46%) survived to hospital discharge, and of these, good discharge outcomes (CPC 1 and 2) were achieved in 21% (5/24). For pesticide intoxication, the survival-to-discharge rate was 62% (8/13), and the rate of good neurologic outcome was 23% (3/13).
CONCLUSION: Patients with OHCA caused by self-inflicted intoxication represented 2.6% of all OHCA patients. They showed a high rate of unwitnessed cardiac arrest and a very low rate of bystander cardiopulmonary resuscitation. Pesticides were the main cause of cardiac arrest, and these cases had a very high discharge to survival rate.
Language: en |