Anticoagulation therapy could improve the restoration of sinus rhythm and spontaneous circulation in hospital patients with CPR

J Int Med Res. 2019 Dec;47(12):5957-5966. doi: 10.1177/0300060519878005. Epub 2019 Oct 8.

Abstract

Objective: To analyse the role of anticoagulation therapy in cardiopulmonary resuscitation (CPR) following an in-hospital cardiac arrest.

Methods: This single-centre retrospective cohort study enrolled patients treated with in-hospital CPR that met the inclusion and exclusion criteria. The patients were divided into a without anticoagulation group and an anticoagulation group. The main outcome measures were the restoration of spontaneous respiration, restoration of sinus rhythm (ROSR), restoration of spontaneous circulation (ROSC) and the hospital mortality.

Results: The study analysed 344 patients: 272 in the without anticoagulation group and 72 in the anticoagulation group. Multiple logistic regression analyses demonstrated that anticoagulation therapy improved ROSR (adjusted odds ratio [OR] 2.21, 95% confidence interval [CI] 1.23, 3.96) and ROSC (adjusted OR 1.91, 95% CI 1.08, 3.40), but it did not improve the restoration of spontaneous respiration (adjusted OR 1.64, 95% CI 0.72, 3.76) and hospital survival (adjusted OR 0.90, 95% CI 0.40, 1.99).

Conclusion: Anticoagulation therapy improved ROSR and ROSC, but did not decrease the mortality rate of hospitalized patients undergoing CPR following in-hospital cardiac arrest.

Keywords: Anticoagulation; cardiopulmonary resuscitation (CPR); hospital mortality; restoration of sinus rhythm (ROSR); restoration of spontaneous circulation (ROSC).

MeSH terms

  • Aged
  • Anticoagulants / pharmacology*
  • Blood Circulation / drug effects*
  • Cardiopulmonary Resuscitation*
  • Cohort Studies
  • Coronary Sinus / drug effects
  • Coronary Sinus / physiopathology*
  • Female
  • Humans
  • Inpatients*
  • Logistic Models
  • Male
  • Respiration

Substances

  • Anticoagulants