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Intensive Care Medicine
Published in: Intensive Care Medicine 6/2014

01-06-2014 | Original

Characteristics and prognosis of sudden cardiac death in Greater Paris

Population-based approach from the Paris Sudden Death Expertise Center (Paris—SDEC)

Authors: Wulfran Bougouin, Lionel Lamhaut, Eloi Marijon, Daniel Jost, Florence Dumas, Nicolas Deye, Frankie Beganton, Jean-Philippe Empana, Emilie Chazelle, Alain Cariou, Xavier Jouven

Published in: Intensive Care Medicine | Issue 6/2014

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Abstract

Purpose

Sudden cardiac death (SCD) is a major public health concern, but data regarding epidemiology of this disease in Western European countries are outdated. This study reports the first results from a large registry of SCD.

Methods

A population-based registry was established in May 2011 using multiple sources to collect every case of SCD in Paris and its suburbs, covering a population of 6.6 million. Utstein variables were recorded. Pre-hospital and in-hospital data were considered, and the main outcome was survival at hospital discharge. Neurologic status at discharge was established as well.

Results

Of the 6,165 cases of SCD recorded over 2 years, 3,816 had a resuscitation attempt and represent the study population. Most patients were male (69 %), the SCD occurred at home (72 %) with bystanders in 80 % of cases, and cardiopulmonary resuscitation (CPR) was performed in 45 % of cases. Initial rhythm was shockable in 26 % of cases. A total of 1,332 patients (35 %) were admitted alive to hospital. Among hospitalized patients, 58 % had a coronary angiogram, and the same proportion had therapeutic hypothermia. Finally, 279 patients (7.5 %) were discharged alive, of whom 96 % had a favorable neurological outcome. In multivariate analysis, bystander CPR (OR 2.1, 95 % CI 1.5–3.1) and initial shockable rhythm (OR 11.5, 95 % CI 7.6–17.3) were positively associated with survival at hospital discharge, whereas age (OR 0.97 per year, 95 % CI 0.96–0.98), longer response time (OR 0.93 per minute, 95 % CI 0.89–0.97), occurrence at home (OR 0.4, 95 % CI 0.3–0.6), and epinephrine dose greater than 3 mg (OR 0.05, 95 % CI 0.03–0.08) were inversely associated with survival.

Conclusion

Despite being conducted in the therapeutic hypothermia and early coronary angiogram era, hospital discharge survival rate of resuscitated SCD remains poor. The current registry suggests ways to improve pre-hospital and in-hospital care of these patients.
Appendix
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Metadata
Title
Characteristics and prognosis of sudden cardiac death in Greater Paris
Population-based approach from the Paris Sudden Death Expertise Center (Paris—SDEC)
Authors
Wulfran Bougouin
Lionel Lamhaut
Eloi Marijon
Daniel Jost
Florence Dumas
Nicolas Deye
Frankie Beganton
Jean-Philippe Empana
Emilie Chazelle
Alain Cariou
Xavier Jouven
Publication date
01-06-2014
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 6/2014
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-014-3252-5

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