Abstract
Introduction
Rearrest occurs when a patient experiences cardiac arrest after successful resuscitation.
The incidence and outcomes of rearrest following out-of-hospital cardiac arrest have
been estimated in limited local studies. We sought provide a large-scale estimate
of rearrest incidence and its effect on survival.
Methods
We obtained case data from emergency medical services-treated, out-of-hospital cardiac
arrest from the Resuscitation Outcomes Consortium, a multi-site clinical research
network with clinical centers in 11 regions in the US and Canada. The cohort comprised
all cases captured between 2006 and 2008 at 10 of 11 regions with prehospital return
of spontaneous circulation. We used three methods to ascertain rearrest via direct
signal analysis, indirect signal analysis, and emergency department arrival vital
status. Rearrest incidence was estimated as the proportion of cases with return of
spontaneous circulation that experience rearrest. Regional rearrest incidence estimates
were compared with the χ2-squared test. Multivariable logistic regression was used to assess the relationship
between rearrest and survival to hospital discharge.
Results
Out of 18,937 emergency medical services-assessed cases captured between 2006 and
2008, 11,456 (60.5%) cases were treated by emergency medical services and 4396 (38.4%)
had prehospital return of spontaneous circulation. Of these, rearrest ascertainment
data was available in 3253 cases, with 568 (17.5%) experiencing rearrest. Rearrest
differed by region (10.2% to 21.2%, p < 0.001). Rearrest was inversely associated with survival (OR: 0.19, 95% CI: 0.14–0.26).
Conclusions
Rearrest was found to occur frequently after resuscitation and was inversely related
to survival.
Keywords
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Article info
Publication history
Published online: October 22, 2014
Accepted:
October 6,
2014
Received in revised form:
August 30,
2014
Received:
May 2,
2014
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2014.10.011.
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
