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J Korean Soc Emerg Med > Volume 22(5); 2011 > Article
Journal of The Korean Society of Emergency Medicine 2011;22(5): 416-422.
Significance of Hypotension after Return of Spontaneous Circulation from Out of Hospital Cardiac Arrest
Youngsun Park, Sangsik Choi, Won Young Kim, Chang Hwan Sohn, Shin An, Dong Woo Seo, Won Kim, Kyoung Soo Lim
Department of Emergency Medicine, College of Medicine University of Ulsan, Asan Medical Center, Seoul, Korea. wonpia@yahoo.co.kr
Arterial hypotension after return of spontaneous circulation (ROSC) from out of hospital cardiac arrest (OHCA) occurs frequently. However, few studies have described post-ROSC hypotension and the relationship with outcome in OHCA. This study aimed to find the prevalence of post-ROSC hypotension and to determine whether post-ROSC hypotension predicts outcome in OHCA.
This was a retrospective cohort study of patients with ROSC (>20 minutes) after OHCA and who were admitted to the emergency department in a tertiary hospital from July, 2005 to June, 2009. Patients' baseline characteristics, presence of arterial hypotension (<90 mmHg), mortality, and neurologic outcome were evaluated. Mortality rates were compared and multivariate logistic regression was used to determine if post-ROSC hypotension independently predicted death.
One hundred forty seven patients (93 males) were studied. Post-ROSC hypotension occurred in 108(73%) patients and was associated with significantly higher mortality compared to non-exposure (82% vs. 44% p<0.001). In multivariate logistic regression analysis, post-ROSC hypotension (OR 4.4 [95% CI]) and non-cardiogenic causes (OR 19.7 [95% CI]) were independent predictors of death.
Post-ROSC hypotension is common and can be an independent predictor of death in OHCA.
Key words: Heart arrest, Resuscitation, Hypotension
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