AUTHOR=Pantel Tobias , Neulen Axel , Mader Marius Marc-Daniel , Kurz Elena , Piffko Andras , Fassl Verena , Westphal Manfred , Gempt Jens , Ringel Florian , Czorlich Patrick 

TITLE=Impact of pre-hospital handling and initial time to cranial computed tomography on outcome in aneurysmal subarachnoid hemorrhage patients with out-of-hospital sudden cardiac arrest—a retrospective bi-centric study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1209939

DOI=10.3389/fcvm.2023.1209939

ISSN=2297-055X

ABSTRACT=Aneurysmal subarachnoid hemorrhage (SAH) presents occasionally with cardiac arrest (CA). The impact of pre-hospital and emergency room (ER) treatment on outcome remains unclear. Therefore, we investigated the impact of pre-hospital treatment, focusing on lay cardiopulmonary resuscitation (CPR), and ER handling on the outcome of SAH patients with out-of-hospital CA (OHCA).In this bi-centric retrospective analysis, we reviewed SAH databases for OHCA and CPR from 01/2011 to 06/2021. Patients were analyzed for general clinical and epidemiological parameters. CPR data were obtained from ambulance reports, information on ER handling from the medical records. Data were correlated with patient survival at hospital discharge as predefined outcome parameter. Of 1120 patients with SAH, 45 patients (4.0%) were identified with OHCA and CPR, 38 of whom provided all required information and were included in this study. Time to resuscitation was significantly shorter with lay resuscitation (5.3±5.2 vs. 0.3±1.2 minutes, p=0.003). 19 Patients were not initially scheduled for CPR, resulting in a significantly longer time interval to first CPR (mean±SD: 154±217 vs. 40±23 minutes; p<0.001). Overall survival to discharge was 31.6%. Prehospital lay CPR was not associated with higher survival (p=0.632). However, we could not demonstrate a statistical correlation to shorter time to first CCT in surviving patients (p=0.065), time to diagnosis should be kept as short as possible.OHCA in SAH patients is not uncommon. Besides high-quality CPR, time to diagnosis of SAH appears to play an important role. We therefore recommend considering CCT diagnostics as part of the diagnostic algorithm in patients with OHCA.