Abstract
Background
Pulmonary hypertension (PH) has been associated with poor survival in multiple cardiopulmonary
conditions, however its association with outcomes in cardiac arrest remains unknown.
We aimed to evaluate the association of PH with survival and neurologic outcomes in
adults with in-hospital cardiac arrest (IHCA).
Methods
The study population included adults with IHCA undergoing resuscitation at an academic
tertiary-care medical center from 2011 to 2019. Patients were classified based upon
the presence versus absence of PH, defined as a pulmonary artery systolic pressure
>35 mmHg on pre-arrest echocardiogram. Survival to discharge and favorable neurological
outcome (defined as a Glasgow Outcome Score of 4–5) served as the primary and secondary
outcomes of interest respectively.
Results
Of the 371 patients studied, 203 (54.7%) had PH while 168 (45.3%) did not. Patients
with PH had higher Charlson Comorbidity Score with higher rates of multiple baseline
comorbidities. They also had worse multi-chamber enlargement, left ventricular diastolic
dysfunction, right ventricular systolic dysfunction, and valvular heart disease compared
to non-PH patients. Rates of survival to discharge (11.5% vs 10.9%, p = 0.881) and favorable neurologic outcome (8.0% vs 6.2%, p = 0.550) were similar in PH and non-PH patients respectively. In multivariable analysis,
PH was not associated with survival to discharge (OR 1.23, 95%CI 0.57–2.65) or favorable
neurologic outcome (OR 1.69, 95%CI 0.64–4.45).
Conclusions
In this contemporary registry of adults with IHCA, while PH was associated with a
higher risk patient profile, it was not associated with survival or neurologic outcomes
in this population.
Keywords
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Article info
Publication history
Published online: June 04, 2022
Accepted:
June 1,
2022
Received in revised form:
May 28,
2022
Received:
February 8,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
