Subarachnoid haemorrhage as a cause of out-of-hospital cardiac arrest: A prospective computed tomography study

Joji Inamasu, Satoru Miyatake, Hideto Tomioka, Masaru Suzuki, Masashi Nakatsukasa, Naoki Maeda, Takeshi Ito, Kunihiko Arai, Masahiro Komura, Kenichi Kase, Kenji Kobayashi

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Aim: Aneurysmal subarachnoid haemorrhage (SAH) is a relatively common cause of out-of-hospital cardiac arrest (OHCA). Early identification of SAH-induced OHCA with the use of brain computed tomography (CT) scan obtained immediately after resuscitation may help emergency physicians make therapeutic decision as quickly as they can. Methods: During the 4-year observation period, brain CT scan was obtained prospectively in 142 witnessed non-traumatic OHCA survivors who remained haemodynamically stable after resuscitation. Demographics and clinical characteristics of SAH-induced OHCA survivors were compared with those with "negative" CT finding. Results: Brain CT scan was feasible with an average door-to-CT time of 40.0 min. SAH was found in 16.2% of the 142 OHCA survivors. Compared with 116 survivors who were negative for SAH, SAH-induced OHCA survivors were significantly more likely to be female, to have experienced a sudden headache, and trended to have achieved return of spontaneous circulation (ROSC) prior to arrival in the emergency department less frequently. Ventricular fibrillation (VF) was significantly less likely to be seen in SAH-induced than SAH-negative OHCA (OR, 0.06; 95% CI, 0.01-0.46). Similarly, Cardiac Trop-T assay was significantly less likely to be positive in SAH-induced OHCA (OR, 0.08; 95% CI, 0.01-0.61). Conclusion: Aneurysmal SAH causes OHCA more frequently than had been believed. Immediate brain CT scan may particularly be useful in excluding SAH-induced OHCA from thrombolytic trial enrollment, for whom the use of thrombolytics is contraindicated. The low VF incidence suggests that VF by itself may not be a common cause of SAH-induced OHCA.

Original languageEnglish
Pages (from-to)977-980
Number of pages4
JournalResuscitation
Volume80
Issue number9
DOIs
Publication statusPublished - 2009 Sep
Externally publishedYes

Fingerprint

Out-of-Hospital Cardiac Arrest
Subarachnoid Hemorrhage
Tomography
Survivors
Ventricular Fibrillation
Brain
Resuscitation
Headache
Hospital Emergency Service
Emergencies

Keywords

  • Brain computed tomography
  • Out-of-hospital cardiac arrest
  • Subarachnoid haemorrhage
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine

Cite this

Inamasu, J., Miyatake, S., Tomioka, H., Suzuki, M., Nakatsukasa, M., Maeda, N., ... Kobayashi, K. (2009). Subarachnoid haemorrhage as a cause of out-of-hospital cardiac arrest: A prospective computed tomography study. Resuscitation, 80(9), 977-980. https://doi.org/10.1016/j.resuscitation.2009.05.010

Subarachnoid haemorrhage as a cause of out-of-hospital cardiac arrest : A prospective computed tomography study. / Inamasu, Joji; Miyatake, Satoru; Tomioka, Hideto; Suzuki, Masaru; Nakatsukasa, Masashi; Maeda, Naoki; Ito, Takeshi; Arai, Kunihiko; Komura, Masahiro; Kase, Kenichi; Kobayashi, Kenji.

In: Resuscitation, Vol. 80, No. 9, 09.2009, p. 977-980.

Research output: Contribution to journalArticle

Inamasu, J, Miyatake, S, Tomioka, H, Suzuki, M, Nakatsukasa, M, Maeda, N, Ito, T, Arai, K, Komura, M, Kase, K & Kobayashi, K 2009, 'Subarachnoid haemorrhage as a cause of out-of-hospital cardiac arrest: A prospective computed tomography study', Resuscitation, vol. 80, no. 9, pp. 977-980. https://doi.org/10.1016/j.resuscitation.2009.05.010
Inamasu, Joji ; Miyatake, Satoru ; Tomioka, Hideto ; Suzuki, Masaru ; Nakatsukasa, Masashi ; Maeda, Naoki ; Ito, Takeshi ; Arai, Kunihiko ; Komura, Masahiro ; Kase, Kenichi ; Kobayashi, Kenji. / Subarachnoid haemorrhage as a cause of out-of-hospital cardiac arrest : A prospective computed tomography study. In: Resuscitation. 2009 ; Vol. 80, No. 9. pp. 977-980.
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AU - Suzuki, Masaru

AU - Nakatsukasa, Masashi

AU - Maeda, Naoki

AU - Ito, Takeshi

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KW - Out-of-hospital cardiac arrest

KW - Subarachnoid haemorrhage

KW - Ventricular fibrillation

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