For a study, researchers sought to look at the long-term survival of adult patients who have survived an out-of-hospital cardiac arrest (OHCA) hospital admission. An iterative technique was used to recreate patient data from Kaplan-Meier curves, then aggregated to generate survival curves. An aggregate data meta-analysis was done as a separate analysis. A total of 15,347 reports were found, with 21 studies (11,800 patients) included in a Kaplan-Meier–based meta-analysis and 33 studies (16,933 patients) included in an aggregate data meta-analysis. The median survival period for patients surviving hospital release was 5.0 years in the Kaplan-Meier study (IQR, 2.3-7.9 years). At 3 years, the estimated survival rates were 82.8% (95% CI, 81.9%-83.7%) at 3 years, 77.0% (95% CI, 75.9%-78.0%) at 5 years, 63.9% (95% CI, 62.3%-65.4%) at 10 years, and 57.5% (95% CI, 54.8%-60.1%) at 15 years. Patients with a shockable first rhythm had a lower risk of long-term mortality than those with a non-shockable initial rhythm (hazard ratio, 0.30; 95% CI, 0.23-0.39; P<.001). These results were verified by other methods, including an aggregate data meta-analysis. In this thorough systematic review and meta-analysis, long-term survival in patients who survived the initial hospital stay after OHCA was between 62% and 64%. More study was needed to understand better and increase long-term survival in this fragile patient population.
Source:jamanetwork.com/journals/jamacardiology/article-abstract/2791886
