AUTHOR=Baldi Enrico , Compagnoni Sara , Buratti Stefano , Primi Roberto , Bendotti Sara , Currao Alessia , Gentile Francesca Romana , Sechi Giuseppe Maria , Mare Claudio , Bertona Roberta , Raimondi Cominesi Irene , Taravelli Erika , Fava Cristian , Danzi Gian Battista , Oltrona Visconti Luigi , Savastano Simone ,  all the Lombardia CARe Researchers , Villa Guido Francesco , Matiz Guido , Migliori Maurizio , Pagliosa Andrea , Canevari Fabrizio , Brancaglione Antonella , Palo Alessandra , Contri Enrico , Ronchi Vincenza , De Pirro Antonella , Molinari Simone , Sgromo Vito , Paglino Martina , Mojoli Francesco , Curti Moreno , Klersy Catherine , Musella Valeria , Carnevale Livio , Marioni Arianna , Bergamini Giuseppe , Reali Francesca , Rizzi Ugo , Bussi Daniele , Ruggeri Simone , Moschini Luigi , Zanotti Laura , Storti Enrico , Parogni Pierpaolo , Facchin Fabio , Buetto Giovanni , Luppi Mario , Franchi Dario , Caresani Matteo , Campi Sabina , Centineo Paola , De Ponti Roberto , Russo Alessandra , Vecchi Andrea Lorenzo , Fantoni Cecilia , Franzosi Cinzia , Vimercati Claudio , Giovenzana Fulvio , Caico Salvatore Ivan , Genoni Paola , Castiglioni Battistina , Botteri Marco , Perone Giovanna , Panni Gianluca , Bettari Luca , Ghiraldin Daniele , Maffeo Diego , Paiella Marco , Piccolo Umberto , Cazzaniga Marco , Passarelli Ilaria 

TITLE=Long-Term Outcome After Out-of-Hospital Cardiac Arrest: An Utstein-Based Analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.764043

DOI=10.3389/fcvm.2021.764043

ISSN=2297-055X

ABSTRACT=Background: No data are available regarding long-term survival of out-of-hospital cardiac arrest (OHCA) patients based on different Utstein subgroups, which are expected to awfully differ in terms of survival. We aimed to provide the first long-term survival analysis of OHCA patients divided according the Utstein categories.
Methods: We analysed all the 4924 OHCAs prospectively enrolled in the LombardiaCARe from 2015 to 2019. Pre-hospital data, survival and cerebral performance category score (CPC) at 1, 6 and 12 months and then every year up to 5 years after the event were analysed for each patient.
Results: A decrease in survival was observed during the follow-up in all the Utstein categories. The risk of death of the “All-EMS treated” group exceeded the general population for all the years of follow-up with standardized mortality ratios (SMRs) of 23 (95%CI,16.8-30.2), 6.8 (95%CI,3.8-10.7), 3.8 (95%CI,1.7-6.7), 4.05 (95%CI,1.9-6.9) and 2.6 (95%CI,1.03-4.8) from the first to the fifth year of follow-up. The risk of death was higher also for the Utstein categories “Shockable bystander witnessed” and “Shockable bystander CPR”: SMRs of 19.4 (95%CI,11.3-29.8) and 19.4 (95%CI,10.8-30.6) for the first year and of 6.8 (95%CI,6.6-13) and 8.1 (95%CI,3.1-15.3) for the second one, respectively. Similar results were observed considering the patients discharged with a CPC 1-2.
Conclusions: the mortality of OHCA patients discharged alive from the hospital is higher than the Italian standard population, also considering those with the most favourable OHCA characteristics and those discharged with good neurological outcome. Long-term follow-up should be included in the next Utstein-style revision.