• Juan R Rey, Juan Caro-Codón, Laura Rodríguez Sotelo, Esteban López-de-Sa, Sandra O Rosillo, Óscar González Fernández, Jaime Fernández de Bobadilla, Ángel M Iniesta, Laura Peña Conde, Isabel Antorrena Miranda, Eduardo Armada, José Ruiz Cantador, and José Luis López-Sendón.
• Cardiology Department, Hospital Universitario La Paz, C/ Paseo de la Castellana, 261, 28046 Madrid, Spain. Electronic address: jreyblas@hotmail.com.
• Eur. J. Intern. Med. 2020 Apr 1; 74: 49-54.

Introduction And ObjectivesInformation regarding long-term outcomes in patients surviving out-of-hospital cardiac arrest (OHCA) is scarce. Our aim was to study the long-term clinical outcomes of a large cohort of OHCA patients surviving until hospital discharge and to identify predictors of mortality and cardiovascular events.MethodsConsecutive OHCA patients admitted in the Acute Cardiac Care Unit who survived at least until hospital discharge between 2007 and 2019 were included. All received therapeutic hypothermia according to the local protocol. Pre- and intra-hospital clinical and analytical variables were analyzed, as well as the clinically relevant events during follow-up.ResultsA total of 201 patients were included, with a mean age of 57.6 ± 14.2 years, 168 (83.6%) were male. Thirty-six (17.9%) died during a median follow-up of 40.3 months (18.9-69.1), the most frequent causes of death being cardiovascular and neurological, followed by cancer. We calculated a predictive model for mortality during follow-up using Cox regression that included the following variables: poor neurological outcome [HR 3.503 (1.578-7.777)], non-shockable rhythm [HR 2.926 (1.390-6.163)], time to onset of CPR [HR 1.063 (0.997-1.134)], older age [1.036 (1.008-1.064)) and worse ejection fraction at discharge [1.033 (1.009-1.058)].ConclusionsEven though few patients experience recurrent cardiac arrest events, survivors after OHCA face high morbidity and mortality during long-term follow-up. Therefore, they may benefit from multidisciplinary teams providing an integral management and ensuring continuity of care.Copyright © 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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