The association between systolic blood pressure on arrival at hospital and outcome in adults surviving from out-of-hospital cardiac arrests of presumed cardiac aetiology

J.E. Bray, S.A. Bernard, K.M. Cantwell, M. Stephenson, Karen Smith

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44 Citations (Scopus)

Abstract

Background: The optimal blood pressure target following successful resuscitation from out-of-hospital cardiac arrest (OHCA) is uncertain. This study aimed to explore the association between level of systolic blood pressure (SBP) on arrival at hospital and survival to hospital discharge. Methods: We analysed eligible OHCAs occurring between January 2003 and December 2011 from the Victorian Ambulance Cardiac Arrest Register (VACAR). Inclusion criteria were: adults (≥18 years), presumed cardiac aetiology, not paramedic witnessed, and ROSC at hospital arrival. Multivariate logistic regression models were performed by initial rhythm (shockable/non-shockable) to examine the relationship between SBP at hospital arrival in 10. mmHg increments and survival to hospital discharge. Models were adjusted for known predictors of survival, including duration of arrest. Results: Of 3620 eligible cases, 14% were hypotensive (SBP. <90. mmHg) on hospital arrival (10% shockable and 19% non-shockable). For patients in shockable rhythms, discharge survival was maximal at 120-129. mmHg (54%), and in the adjusted model (≥120. mmHg as reference) SBP decrements below 90. mmHg were associated with lower survival: 80-89. mmHg AOR. = 0.49 (95% CI: 0.24-0.95);
Original languageEnglish
Pages (from-to)509-515
JournalResuscitation
Volume85
Issue number4
DOIs
Publication statusPublished - Apr 2014

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