Long-term follow-up after out-of-hospital cardiac arrest

Survival rate after out-of-hospital cardiac arrest varies according to evaluation criteria. It can be estimated that in 22 to 63% of the cases, effective hemodynamic performance is restored although hospital mortality is much higher, reaching 63%. Death, frequent after prolonged cardiac arrest, is usually due to recurrent cardiac arrest or the effects of prolonged anoxia. Mortality in patients who survive the hospitalization period is approximately 20% during the year following discharge. Consequently one year after out-of-hospital cardiac arrest, only 5% of the patients are still alive. The quality of life varies greatly in these survivors; the course of neurological sequellae may be favorable in approximately half but leads to death in others. The primary factor predicting survival is the underlying pathology, highly influenced by age. Inversely, factors predicting a more favorable outcome include ventricular tachycardia as the origin of cardiac arrest, presence of other people at onset and rapid recovery of spontaneous hemodynamic activity. Loss of consciousness for more than 24 hours, defective bulbar reflexes and anomalies on the electroencephalogram are signs of gravity as are high blood glucose, major brain edema and abolition of somesthesic and auditive evoked potentials.