Cardiovascular risk factors differently affect the survival of patients undergoing manual or mechanical resuscitation

BMC Cardiovasc Disord. 2018 Dec 7;18(1):227. doi: 10.1186/s12872-018-0962-6.

Abstract

Background: Chest compression is a decisive element of cardio-pulmonary resuscitation (CPR). By applying a mechanical CPR device, compression interruptions can be minimised. We examined the efficiency of manual and device-assisted resuscitation as well as the effects of cardiovascular risk factors on the outcome of resuscitation.

Methods: In our retrospective, randomised 3-year study the data of adult patients suffering non-traumatic, out-of-hospital, sudden cardiac death (SCD) were analysed (n = 287). The data were retrieved by processing case reports, Utstein sheets and acute coronary syndrome sheets. We compared the data of patients undergoing manual (n = 232) and device-assisted resuscitation (LUCAS-2, n = 55). The primary endpoint was the on-site restoration of spontaneous circulation (ROSC).

Results and conclusion: In 37% of the cases ROSC happened. With respect to ROSC an insignificantly more favourable tendency was demonstrated in the case of device-assisted resuscitation (p = 0.072). In the Lucas group, a higher success rate occurred even in the case of prolonged resuscitation. We found a better outcome in the Lucas group in the case of CPR started a longer time after the SCD (p < 0.05). A positive correlation was established between age and unsuccessful resuscitation (p = < 0.017; r = 0.125). An unfavourable correlation was observed between hypertension and the outcome of resuscitation (p = 0.018; r = 0.143). According to our results the presence of left ventricular hypertrophy poses 5.1-fold risk of unsuccessful CPR (CI: 4.97-5.29). Advanced age and structural heart diseases can play a role in the genesis of SCD. Importantly, left ventricular hypertrophy and hypertension negatively affect survival.

Keywords: Chest compression; Resuscitation; Sudden cardiac death.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiopulmonary Resuscitation / adverse effects
  • Cardiopulmonary Resuscitation / instrumentation*
  • Cardiopulmonary Resuscitation / mortality
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control*
  • Female
  • Heart Arrest / etiology
  • Heart Arrest / mortality
  • Heart Arrest / physiopathology
  • Heart Arrest / therapy*
  • Heart Massage / adverse effects
  • Heart Massage / instrumentation*
  • Heart Massage / mortality
  • Humans
  • Hypertension / complications*
  • Hypertension / diagnosis
  • Hypertension / mortality
  • Hypertension / physiopathology
  • Hypertrophy, Left Ventricular / complications*
  • Hypertrophy, Left Ventricular / diagnosis
  • Hypertrophy, Left Ventricular / mortality
  • Hypertrophy, Left Ventricular / physiopathology
  • Male
  • Middle Aged
  • Recovery of Function
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome