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. 2024 Aug 10:19:100737.
doi: 10.1016/j.resplu.2024.100737. eCollection 2024 Sep.

Post cardiac arrest left ventricular ejection fraction associated with survival to discharge

Kanjit Leungsuwan  1 , Kory R Heier  1 , Olivia Henderson  1 , Karam Ayoub  1 , Talal Alnabelsi  1 , Emily Slade  1 , Vedant A Gupta  1
Affiliations

Post cardiac arrest left ventricular ejection fraction associated with survival to discharge

Kanjit Leungsuwan et al. Resusc Plus. .

Abstract

Background: Post cardiac arrest left ventricular ejection fraction (LVEF) is routinely assessed, but the implications of this are unknown. This study aimed to assess the association between post cardiac arrest LVEF and survival to hospital discharge.

Methods: In this retrospective cohort study, all in-hospital and out of hospital cardiac arrests at our tertiary care center between January 2012 and September 2015 were included. Baseline demographics, clinical data, characteristics of the arrest, and interventions performed were collected. Earliest post cardiac arrest echocardiograms were reviewed with LVEF documented. The primary outcome was survival to discharge.

Results: A total of 736 patients were included in the analysis (mean age 58 years, 44% female). 15% were out of hospital cardiac arrest (24% shockable rhythm). After adjusting for covariates, patients with LVEF < 30% had 36% lower odds of surviving to hospital discharge than those with LVEF ≥ 52% (p = 0.014). Shockable initial rhythm and targeted temperature management were associated with improved survival.

Conclusion: After a cardiac arrest, an initial LVEF < 30% is associated with significantly lower odds of survival to hospital discharge.

Keywords: Cardiac arrest; Left ventricular ejection fraction; Post arrest care; Survival to hospital discharge.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Patient flow.
Fig. 2
Fig. 2
Forest Plot of Adjusted Odds Ratios from Logistic Regression Model for Survival to Discharge. Caption: Diamonds indicate odds ratio point estimates, and bars indicate 95% confidence intervals. Abbreviations: LVEF, left ventricular ejection fraction.
Fig. 3
Fig. 3
Probability of Surviving to Discharge by Severe LV Dysfunction and Initial Shockable Rhythm (A) and by Severe LV Dysfunction and Arrest Type (B). Caption: Plot shows predicted probabilities with 95% prediction intervals from a logistic regression model including severe LV dysfunction, initial shockable rhythm (A) or arrest type (B), and their interaction. Severe LV dysfunction refers to left ventricular ejection fraction < 30%. Abbreviations: LV left ventricle.
See this image and copyright information in PMC

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