Survival Improving After Out-of-Hospital Heart Attacks
Thousands of persons are discharged from the hospital each year in the United States following successful resuscitation from out-of-hospital cardiac arrest. The long-term prognosis for these survivors appears to be improving.
A study published in the Aug. 25, 2003 edition of Circulation found that long-term survival after successful resuscitation and hospital discharge has improved steadily and substantially over the past several years. The specific cause of this trend is unknown.
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"We could not pinpoint a reason," said Dr. Thomas Rea, assistant professor of medicine and leader of the study. "It is likely multi-factorial. There have been improvements in medicine and health behaviors such as diet and exercise."
Beneficial therapies for persons with heart disease are also more readily available. For example, the use of coronary revascularization as either bypass surgery or percutaneous intervention, both associated with improved survival among persons resuscitated from sudden cardiac arrest, has increased several-fold during the 1980s and 1990s, with ongoing improvements in approach and technique. Similarly, the use of pharmacotherapies, such as aspirin or lipid-lowering medications, that have been demonstrated to reduce mortality in various heart disease populations, has also increased.
Because King County has a high percentage of people trained in cardiopulmonary resuscitation, about 15 percent of cardiac arrest victims in King County leave the hospital alive after being treated, as opposed to five percent nationwide. UW investigators, in collaboration with the Emergency Medical Services Division of Public Health in Seattle and King County, examined this 15 percent of cases in which the patient went home after hospitalization for cardiac arrest. The 2,035 cases examined were from May 1, 1976, to December 31, 2001, and were in King County, excluding Seattle. After looking at the length of time between the date of discharge and the date of death in each case, the study found that people who recover from a sudden cardiac arrest are living much longer and the long-term prognosis appears to be improving.