PMID- 18951683
OWN - NLM
STAT- MEDLINE
DCOM- 20090310
LR  - 20201216
IS  - 0300-9572 (Print)
IS  - 1873-1570 (Electronic)
IS  - 0300-9572 (Linking)
VI  - 79
IP  - 3
DP  - 2008 Dec
TI  - Cardiac catheterization is underutilized after in-hospital cardiac arrest.
PG  - 398-403
LID - 10.1016/j.resuscitation.2008.07.015 [doi]
AB  - BACKGROUND: Indications for immediate cardiac catheterization in cardiac arrest 
      survivors without ST elevation myocardial infarction (STEMI) are uncertain as 
      electrocardiographic and clinical criteria may be challenging to interpret in 
      this population. We sought to evaluate rates of early catheterization after 
      in-hospital ventricular fibrillation (VF) arrest and the association with 
      survival. METHODS: Using a billing database we retrospectively identified cases 
      with an ICD-9 code of cardiac arrest (427.5) or VF (427.41). Discharge summaries 
      were reviewed to identify in-hospital VF arrests. Rates of catheterization on the 
      day of arrest were determined by identifying billing charges. Unadjusted analyses 
      were performed using Chi-square, and adjusted analyses were performed using 
      logistic regression. RESULTS: One hundred and ten in-hospital VF arrest survivors 
      were included in the analysis. Cardiac catheterization was performed immediately 
      or within 1 day of arrest in 27% (30/110) of patients and of these patients, 57% 
      (17/30) successfully received percutaneous coronary intervention. Of those who 
      received cardiac catheterization the indication for the procedure was STEMI or 
      new left bundle branch block (LBBB) in 43% (13/30). Therefore, in the absence of 
      standard ECG data suggesting acute myocardial infarction, 57% (17/30) received 
      angiography. Patients receiving cardiac catheterization were more likely to 
      survive than those who did not receive catheterization (80% vs. 54%, p<.05). 
      CONCLUSION: In patients receiving cardiac catheterization, more than half 
      received this procedure for indications other than STEMI or new LBBB. Cardiac 
      catheterization was associated with improved survival. Future recommendations 
      need to be established to guide clinicians on which arrest survivors might 
      benefit from immediate catheterization.
FAU - Merchant, Raina M
AU  - Merchant RM
AD  - The Robert Wood Johnson Clinical Scholars Program, University of Pennsylvania, 
      School of Medicine, Philadelphia, PA 19104, United States. 
      raina.merchant@uphs.upenn.edu
FAU - Abella, Benjamin S
AU  - Abella BS
FAU - Khan, Monica
AU  - Khan M
FAU - Huang, Kuang-Ning
AU  - Huang KN
FAU - Beiser, David G
AU  - Beiser DG
FAU - Neumar, Robert W
AU  - Neumar RW
FAU - Carr, Brendan G
AU  - Carr BG
FAU - Becker, Lance B
AU  - Becker LB
FAU - Vanden Hoek, Terry L
AU  - Vanden Hoek TL
LA  - eng
GR  - UL1 RR024999/RR/NCRR NIH HHS/United States
GR  - UL1 RR024999-01/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20081031
PL  - Ireland
TA  - Resuscitation
JT  - Resuscitation
JID - 0332173
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Catheterization/*statistics & numerical data
MH  - Female
MH  - Heart Arrest/*therapy
MH  - *Hospitalization
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Ventricular Fibrillation/therapy
PMC - PMC2790918
MID - NIHMS131692
COIS- Conflicts of interest: Raina M. Merchant, MD: no conflict of interest Benjamin S. 
      Abella, MD, MPhil: Grants (Philips Medical Systems, Cardiac Science Corp), 
      Honoraria/Speaking Fees (Medic First Aid, Alsius Corp, Laerdal) Monica Khan: no 
      conflict of interest Kuang-Ning Huang, BA: no conflict of interest David B. 
      Beiser, MD: no conflict of interest Robert W. Neumar, MD PhD: no conflict of 
      interest Brendan G. Carr, MD MA: no conflict of interest Lance B. Becker, MD: 
      Grants (Phillips Medical Systems, Laerdal Medical, Alsius Corporation, NIH, 
      Cardiac Science), Scientific consultant (honoraria/speaking fees): (Abbott Labs, 
      Philips Medical Systems), Patents (Hypothermia Induction Patents), Ownership, 
      equity, royalties in privately held companies (Inventor's equity and royalties 
      from Cold Core Therapeutics', INC, a company developing cooling technologies for 
      medical cooling using "slurry" technology) Terry L. Vanden Hoek, MD: Grants 
      (Department of Defense, Office of Naval Research, Philips Medical Systems), 
      Research Support (Medivance), Patents (Hypothermia Induction Devices and Methods)
EDAT- 2008/10/28 09:00
MHDA- 2009/03/11 09:00
PMCR- 2009/12/09
CRDT- 2008/10/28 09:00
PHST- 2008/04/10 00:00 [received]
PHST- 2008/07/22 00:00 [revised]
PHST- 2008/07/24 00:00 [accepted]
PHST- 2008/10/28 09:00 [pubmed]
PHST- 2009/03/11 09:00 [medline]
PHST- 2008/10/28 09:00 [entrez]
PHST- 2009/12/09 00:00 [pmc-release]
AID - S0300-9572(08)00606-0 [pii]
AID - 10.1016/j.resuscitation.2008.07.015 [doi]
PST - ppublish
SO  - Resuscitation. 2008 Dec;79(3):398-403. doi: 10.1016/j.resuscitation.2008.07.015. 
      Epub 2008 Oct 31.