• Kathrine B Sondergaard, Signe Riddersholm, Mads Wissenberg, Moller HansenSteenSDepartment of Health Science and Technology, Aalborg University, Aalborg, Denmark; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark., Carlo Alberto Barcella, Lena Karlsson, Kristian Bundgaard, Freddy K Lippert, Jesper Kjaergaard, Gunnar H Gislason, Fredrik Folke, Christian Torp-Pedersen, and Kristian Kragholm.
• Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. Electronic address: kbso@dadlnet.dk.
• Resuscitation. 2020 Mar 1; 148: 251-258.

AimTo investigate the association between consciousness status at hospital arrival and long-term outcomes in out-of-hospital cardiac arrest (OHCA) patients.MethodsOHCAs between 18-100 years of age were identified from the Danish Cardiac Arrest Registry during 2005-2014. Patients with return of spontaneous circulation (ROSC) or ongoing cardiopulmonary resuscitation (CPR) at hospital arrival were included. Thirty-day survival was evaluated using Kaplan-Meier estimates. Risk of anoxic brain damage or nursing home admission and return to work among 30-day survivors were evaluated using Aalen-Johansen estimates and cause-specific Cox regression.ResultsUpon hospital arrival of 13,953 OHCA patients, 776 (5.6%) had ROSC and were conscious (Glasgow Coma Score [GCS]>8), 5205 (37.3%) had ROSC, but were comatose (GCS ≤ 8), and 7972 (57.1%) had ongoing CPR. Thirty-day survival according to status at hospital arrival among patients that were conscious, comatose, or had ongoing CPR was 89.0% (95% confidence interval [CI] 86.8%-91.2%), 39.0% (95% CI 37.6%-40.3%), and 1.2% (95% CI 1.0%-1.4%), respectively. Among 30-day survivors, 1-year risks of new onset anoxic brain damage or nursing home admission according to consciousness status were 2.4% (95% CI 1.2%-3.6%), 12.9% (95% CI 11.4%-14.3%), and 19.4% (95% CI 11.3%-27.4%), respectively. Among 30-day working-age survivors, more than 65% in each group returned to work within 5 years.ConclusionConsciousness status at hospital arrival was strongly associated with 30-day survival in OHCA patients. Among 30-day survivors, a minority was diagnosed with anoxic brain damage or admitted to a nursing home and the majority returned to work independent of consciousness status at hospital arrival.Copyright © 2019 Elsevier B.V. All rights reserved.

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