Prognostic value of transient conduction disturbance in out-of-hospital cardiac arrest.

Abstract

A retrospective observational study to verify the impact of electrocardiograms (ECGs) following out-of-hospital cardiac arrest (OHCA) on mortality. We retrospectively studied 101 OHCA patients who achieved a return of spontaneous circulation (ROSC) and survived for ≥3h. Among them, 50 patients (66±17years; 22 male) were evaluated using 12-lead ECGs repeatedly and were included in the final analysis: immediately after ROSC (initial ECG) and after the initial evaluation in the emergency department (second ECG). Transient conduction disturbance (transient CD) was defined as a narrowing in QRS duration from the initial to second ECG of ≥18ms. Multivariate Cox regression analyses were carried out to predict 90-day mortality following OHCA. Among 50 OHCA patients, 30 patients survived for 90days. Thirty patients had initial ventricular fibrillation rhythm. Median emergency medical services response time and low-flow duration were 8 and 21min, respectively. Multivariate analysis showed that the transient CD and low-flow duration were significant predictors of all-cause mortality (hazard ratio 16.55, 1.06; P=0.001, 0.022, respectively). Transient CD is a powerful predictor of 90-day mortality in patients who survived 3h after ROSC from OHCA.