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 language | English |
|---|---|
| Pages (from-to) | 977-980 |
| Number of pages | 4 |
| Journal | Resuscitation |
| Volume | 80 |
| Issue number | 9 |
| DOIs | |
| Publication status | Published - 2009 Sep |
| Externally published | Yes |
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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
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 journal › Article
}
TY - JOUR
T1 - Subarachnoid haemorrhage as a cause of out-of-hospital cardiac arrest
T2 - A prospective computed tomography study
AU - Inamasu, Joji
AU - Miyatake, Satoru
AU - Tomioka, Hideto
AU - Suzuki, Masaru
AU - Nakatsukasa, Masashi
AU - Maeda, Naoki
AU - Ito, Takeshi
AU - Arai, Kunihiko
AU - Komura, Masahiro
AU - Kase, Kenichi
AU - Kobayashi, Kenji
PY - 2009/9
Y1 - 2009/9
N2 - 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.
AB - 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.
KW - Brain computed tomography
KW - Out-of-hospital cardiac arrest
KW - Subarachnoid haemorrhage
KW - Ventricular fibrillation
UR - http://www.scopus.com/inward/record.url?scp=68349098952&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=68349098952&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2009.05.010
DO - 10.1016/j.resuscitation.2009.05.010
M3 - Article
C2 - 19581033
AN - SCOPUS:68349098952
VL - 80
SP - 977
EP - 980
JO - Resuscitation
JF - Resuscitation
SN - 0300-9572
IS - 9
ER -