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Temporal trends of survival and utilization of mechanical circulatory support devices in patients with in-hospital cardiac arrest secondary to ventricular tachycardia/ventricular fibrillation.
- Source :
-
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2019 Oct 01; Vol. 94 (4), pp. 578-587. Date of Electronic Publication: 2019 Feb 21. - Publication Year :
- 2019
-
Abstract
- Background: Pulseless ventricular tachycardia/ventricular fibrillation (VT/VF) is the initial rhythm in a third of in-hospital cardiac arrest patients. Mechanical circulatory support (MCS) device use remains poorly understood in this population.<br />Methods: We conducted an observational analysis of temporal trends in the utilization of MCS in VT/VF IHCA between January 2008 and December 2014 utilizing the Nationwide Inpatient Sample (NIS) database. Using multivariable analysis, we assessed factors associated with MCS use and survival to discharge.<br />Results: Among 151,628 hospitalizations with VT/VF IHCA, 14,981 (9.9%) received MCS. Intra-aortic balloon pump (IABP) was the most commonly used MCS (9.1%). From 2008 to 2014, there was significant increase in the utilization of MCS (8.7-11%; p <subscript>trend</subscript> < 0.0001). On multivariable analysis, there was 12-fold increase and three-fold increase in the utilization of PVAD and ECMO respectively; however, there was no significant change in the use of IABP. Over the seven-year sample period, there was significant increase in the overall survival to hospital discharge (35.4-43.5%; p <subscript>trend</subscript> < 0.0001). Survival to hospital discharge increased in both MCS and non-MCS groups.<br />Conclusion: There was significant increase in utilization of MCS after VT/VF IHCA during the study period. IABP was the most commonly utilized MCS. The survival to hospital discharge increased in the overall study population including both MCS and non-MCS groups. Future studies are needed to identify patient population most likely to benefit from the use of MCS after VT/VF IHCA.<br /> (© 2019 Wiley Periodicals, Inc.)
- Subjects :
- Aged
Aged, 80 and over
Databases, Factual
Extracorporeal Membrane Oxygenation adverse effects
Extracorporeal Membrane Oxygenation instrumentation
Extracorporeal Membrane Oxygenation mortality
Female
Heart Arrest etiology
Heart Arrest mortality
Heart Arrest physiopathology
Humans
Intra-Aortic Balloon Pumping adverse effects
Intra-Aortic Balloon Pumping instrumentation
Intra-Aortic Balloon Pumping mortality
Male
Middle Aged
Risk Factors
Tachycardia, Ventricular mortality
Tachycardia, Ventricular physiopathology
Time Factors
Treatment Outcome
United States
Ventricular Fibrillation mortality
Ventricular Fibrillation physiopathology
Extracorporeal Membrane Oxygenation trends
Heart Arrest therapy
Heart-Assist Devices trends
Intra-Aortic Balloon Pumping trends
Oxygenators, Membrane trends
Practice Patterns, Physicians' trends
Tachycardia, Ventricular complications
Ventricular Fibrillation complications
Subjects
Details
- Language :
- English
- ISSN :
- 1522-726X
- Volume :
- 94
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
- Publication Type :
- Academic Journal
- Accession number :
- 30790415
- Full Text :
- https://doi.org/10.1002/ccd.28138