The quality of care and long-term mortality of out of hospital cardiac arrest survivors after acute myocardial infarction : a nationwide cohort study
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology..
BACKGROUND: The long-terms outcomes of out of hospital cardiac arrest (OHCA) survivors are not well known.
METHODS: Using the Myocardial Ischaemia National Audit Project (MINAP) registry, linked to Office for National Statistics (ONS) mortality data, we analysed 661 326 England, Wales and Northern-Ireland AMI patients; 14 127 (2%) suffered OHCA and survived beyond thirty-days of hospitalisation. Patients dying within thirty-days of admission were excluded. Mean follow-up for patients included was 1 500 days. Cox regression models were fitted, adjusting for demographics and management strategy.
RESULTS: OHCA survivors were younger (in years) (64 (interquartile range [IQR] 54-72) vs. 70 (IQR 59-80), P < 0.001), more often underwent invasive coronary angiography (88% vs. 71%, P < 0.001) and percutaneous coronary intervention (72% vs. 45%, P < 0.001). Overall, risk of mortality for OHCA patients that survived past 30-days was lower than patients that did not suffer cardiac arrest (adjusted hazard ratio [HR] 0.91; 95% CI; 0.87-0.95, P < 0.001). 'Excellent care' according to the mean opportunity-based quality indicator (OBQI) score compared to 'Poor care', predicted reduced risk of long-term mortality post OHCA, for all-patients (HR: 0.77, CI; 0.76-0.78, P < 0.001), more for STEMI patients (HR: 0.73, CI; 0.71-0.75, P < 0.001), but less significantly in NSTEMI patients (HR: 0.79, CI; 0.78-0.81, P < 0.001).
CONCLUSIONS: Out of hospital cardiac arrest (OHCA) patients remain at significant risk of mortality in-hospital. However, if surviving over thirty-days post arrest, OHCA survivors have good longer-term survival up to ten-years compared to the general AMI population. Higher quality inpatient care appears to improve long-term survival in all OHCA patients, more so in STEMI.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
European heart journal. Quality of care & clinical outcomes - (2024) vom: 15. Feb. |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Weight, Nicholas [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Revised 17.02.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1093/ehjqcco/qcae015 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM368566919 |
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| 100 | 1 | |a Weight, Nicholas |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The quality of care and long-term mortality of out of hospital cardiac arrest survivors after acute myocardial infarction |b a nationwide cohort study |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. | ||
| 520 | |a BACKGROUND: The long-terms outcomes of out of hospital cardiac arrest (OHCA) survivors are not well known | ||
| 520 | |a METHODS: Using the Myocardial Ischaemia National Audit Project (MINAP) registry, linked to Office for National Statistics (ONS) mortality data, we analysed 661 326 England, Wales and Northern-Ireland AMI patients; 14 127 (2%) suffered OHCA and survived beyond thirty-days of hospitalisation. Patients dying within thirty-days of admission were excluded. Mean follow-up for patients included was 1 500 days. Cox regression models were fitted, adjusting for demographics and management strategy | ||
| 520 | |a RESULTS: OHCA survivors were younger (in years) (64 (interquartile range [IQR] 54-72) vs. 70 (IQR 59-80), P < 0.001), more often underwent invasive coronary angiography (88% vs. 71%, P < 0.001) and percutaneous coronary intervention (72% vs. 45%, P < 0.001). Overall, risk of mortality for OHCA patients that survived past 30-days was lower than patients that did not suffer cardiac arrest (adjusted hazard ratio [HR] 0.91; 95% CI; 0.87-0.95, P < 0.001). 'Excellent care' according to the mean opportunity-based quality indicator (OBQI) score compared to 'Poor care', predicted reduced risk of long-term mortality post OHCA, for all-patients (HR: 0.77, CI; 0.76-0.78, P < 0.001), more for STEMI patients (HR: 0.73, CI; 0.71-0.75, P < 0.001), but less significantly in NSTEMI patients (HR: 0.79, CI; 0.78-0.81, P < 0.001) | ||
| 520 | |a CONCLUSIONS: Out of hospital cardiac arrest (OHCA) patients remain at significant risk of mortality in-hospital. However, if surviving over thirty-days post arrest, OHCA survivors have good longer-term survival up to ten-years compared to the general AMI population. Higher quality inpatient care appears to improve long-term survival in all OHCA patients, more so in STEMI | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Out of Hospital Cardiac arrest | |
| 650 | 4 | |a Survival | |
| 700 | 1 | |a Moledina, Saadiq |e verfasserin |4 aut | |
| 700 | 1 | |a Hennessy, Tommy |e verfasserin |4 aut | |
| 700 | 1 | |a Jia, Haibo |e verfasserin |4 aut | |
| 700 | 1 | |a Banach, Maciej |e verfasserin |4 aut | |
| 700 | 1 | |a Rashid, Muhammad |e verfasserin |4 aut | |
| 700 | 1 | |a Siller-Matula, Jolanta M |e verfasserin |4 aut | |
| 700 | 1 | |a Thiele, Holger |e verfasserin |4 aut | |
| 700 | 1 | |a Mamas, Mamas A |e verfasserin |4 aut | |
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