The following is a summary of “Prognostic implication of heart failure stage and left ventricular ejection fraction for patients with in-hospital cardiac arrest: a 16-year retrospective cohort study,” published in the February 2024 issue of Cardiology by Wang et al.
The 2022 AHA/ACC/HFSA guidelines tailor heart failure (HF) treatment based on individual patient characteristics.
Researchers conducted a retrospective study to assess the potential of HF stage and left ventricular ejection fraction (LVEF) in predicting in-hospital cardiac arrest (IHCA) outcomes.
They examined data from patients who encountered IHCA (2005 to 2020). Patients were divided into groups based on their admission diagnosis, medical history, and pre-arrest echocardiography: general IHCA, at risk for HF), pre-HF, HF with preserved ejection fraction (HFpEF), and heart failure with mildly reduced or reduced ejection fraction (HFmrEF or HFrEF).
The results showed that 2,466 patients, with 485 (19.7%), 546 (22.1%), 863 (35.0%), 342 (13.9%), and 230 (9.3%) patients falling into the categories of general IHCA, at-risk for HF, pre-HF, HFpEF, and HFmrEF-or-HFrEF, respectively. Of these patients, 405 (16.4%) survived hospital discharge, and 228 (9.2%) achieved favorable neurological recovery. The multivariable logistic regression analysis revealed that pre-HF and HFpEF were linked to improved neurological (pre-HF, OR: 2.11, 95% CI: 1.23–3.61, P=0.006; HFpEF, OR: 1.90, 95% CI: 1.00–3.61, P=0.05) and survival outcomes (pre-HF, OR: 2.00, 95% CI: 1.34–2.97, P<0.001; HFpEF, OR: 1.91, 95% CI: 1.20–3.05, P=0.007) than general IHCA.
They concluded that HF stage and LVEF predicted IHCA prognosis, with pre-HF/HFpEF indicating better outcomes. Further research on HF-tailored management following IHCA is needed.
Source: link.springer.com/article/10.1007/s00392-024-02403-8
