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J Korean Soc Emerg Med > Volume 27(6); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(6): 540-548.
병원 외 심정지 후 자발순환회복 환자에서 소생 후 관상동맥조영술, 경피적관상동맥중재술의 시행과 생존율, 신경학적 예후와의 관계
박준교1, 나상훈1,2,3, 김태한1,4, 신상도1,4, 송경준1,4, 노영선4, 안기옥4
1서울대학교병원 응급의학과
2서울대학교병원 순환기내과
3서울대학교 노화고령사회 연구소
4서울대학교병원 의생명연구원 응급의료연구실
Association of Coronary Angiography and Percutaneous Coronary Intervention to Survival Outcome of Patients Successfully Resuscitated from Out-of-Hospital Cardiac Arrest
Jun-Kyo Park1, Sang-Hoon Na1,2,3, Tae Han Kim1,4, Sang Do Shin1,4, Kyoung Jun Song1,4, Young Sun Ro4, Ki Ok Ahn4
1Department of Emergency Medicine, Seoul National University College of Medicine
2Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital
3Seoul National University Institute Aging
4Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute
Correspondence  Sang-Hoon Na ,Tel: 02-2072-0855, Fax: 02-3674-0805, Email: nasanghoon@gmail.com,
Received: June 29, 2016; Revised: June 30, 2016   Accepted: August 22, 2016.  Published online: December 31, 2016.
ABSTRACT
Purpose:
The aim of this study was to evaluate the association between coronary angiography (CAG) with or without percutaneous coronary intervention (PCI) and the survival outcome of patients successfully resuscitated from out-of-hospital cardiac arrest.
Method:
We used the Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiological Surveillance database, which is out of hospital cardiac arrest (OHCA) cohort of 27 emergency departments in Korea, between February 2014 and January 2015. The inclusion criteria were all OHCA patients who receive cardiopulmonary resuscitation in an emergency department and return of spontaneous circulation. Univariable analysis and multivariable logistic regression analysis were conducted to assess the associations between CAG and outcomes (favorable neurological outcome and survival- to-discharge). Moreover, similar analysis was conducted between PCI and no-PCI subgroups within the CAG group.
Results:
Of the 1,616 patients, 707 patients were return of spontaneous circulation. The number of patients who conducted CAG was 204 (28.9%) and the number of patients who conducted PCI was 75 (10.6%). In OHCA patients, the CAG group had a more significant good survival discharge outcome with an odds ratio (OR) of 4.61 (95% confidence interval [CI], 2.64-8.05) and good neurologic outcomes with an OR of 7.82 (95% CI, 4.37-14.00). In CAG patients, the PCI group had no significant relationship with survival discharge with an OR of 0.99 (95% CI, 0.36-2.70) and with neurologic outcomes with an OR of 1.15 (95% CI, 0.46-2.88) compared with no PCI group.
Conclusion:
In OHCA patients, the CAG group had a more significant good prognosis (survival discharge rate and good neurologic outcomes) compared with the no-CAG group. In CAG patients, the PCI group had no significant association with good prognosis compared with the no-PCI group.
Key words: Cardiac arrest, Coronary angiography, Prognosis
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