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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2019

Open Access 01-12-2019 | Brain Death | Research

Risk factors for progression toward brain death after out-of-hospital cardiac arrest

Authors: Martin Cour, Jean Turc, Thomas Madelaine, Laurent Argaud

Published in: Annals of Intensive Care | Issue 1/2019

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Abstract

Background

Successfully resuscitated out-of-hospital cardiac arrest (OHCA) may lead to brain death (BD) and good-quality transplantable organs. We aimed to determine risk factors for evolution toward BD after OHCA. We analyzed adult patients admitted to an intensive care unit (ICU) who survived at least 24 h after an OHCA between 2005 and 2015. BD was defined according to international guidelines. Multivariate logistic regression was used to identify potential risk factors for BD available 24 h after OHCA.

Results

A total of 214 patients were included (median age 68 years; sex ratio 1.25; non-shockable OHCA: 88%). Among these, 42 (19.6%) developed BD, while 22 (10.3%) were alive at 1 year with a good neurological outcome. Independent risk factors for BD were age (OR per year 0.95; 95% CI [0.92–0.98]), female gender (OR 2.34; 95% CI [1.02–5.35]), neurological cause of OHCA (OR 14.72; 95% CI [3.03–71.37]), duration of the low-flow period > 16 min (OR 2.94, 95% CI [1.21–7.16]) and need of vasoactive drugs at 24 h (OR 6.20, 95% CI [2.41–15.93]).

Conclusions

The study identified, in a population of OHCA with predominantly non-shockable initial rhythms, five simple risk factors independently associated with progression toward BD.
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Metadata
Title
Risk factors for progression toward brain death after out-of-hospital cardiac arrest
Authors
Martin Cour
Jean Turc
Thomas Madelaine
Laurent Argaud
Publication date
01-12-2019
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2019
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-019-0520-0

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