22 OUT-OF-HOSPITAL CARDIAC ARREST IN YOUNG ADULTS AGED 45 YEARS OR YOUNGER

International Journal of Innovative Medicine and Health Science, Vol. 3, 2014, 9-14

Martin Christ, Martin Grett, Katharina Isabel von Auenmüller, Wolfgang Dierschke, Hans-Joachim Trappe

Department of Cardiology and Angiology, Marienhospital Herne, Ruhr – University Bochum, Germany

Download

Email

Description

Abstract

Introduction: We know about factors that influence survival following out-of-hospital cardiac arrest. Nevertheless, most studies describe the treatment of victims of OHCA in general. We therefore initiated this study to determine whether there are special features of the post-resuscitation treatment of young adults.

Material and methods: All victims of OHCA (age 17–45 years) who were admitted to our intensive care unit between January 1st 2008 and December 31st 2013 were registered and their medical reports were stored in a central database.

Results: There were 15 victims of nontraumatic OHCA aged 45 years or younger: seven men (46.7%) and eight women (53.3%). Return of spontaneous circulation (ROSC) prior to hospital admission was achieved in nine patients (60.0%), five patients (33.3%) received mild therapeutic hypothermia (MTH), and six patients received percutaneous coronary intervention (PCI). Myocardial infarction was the most common cause of death (40.0%), including in two patients following prior heart operations. The survival rate was 53.3%; seven out of eight patients discharged alive had a good neurological state (CPC 1).

Discussion: The prevalence of nontraumatic OHCA in patients aged 45 years or younger is rare and we could not find any relevant differences between the post-resuscitation findings in young adults and those described for victims of OHCA in general beside a higher rate of application of MTH among the younger patients.

The main finding of our study was the surprisingly high prevalence of cardiac causes of OHCA with myocardial infarction as the most common cause of death despite the young age of our patients collective.

Conclusion: As cardiac causes of OHCA were the most common finding in our study of young victims from OHCA, we recommend that especially young victims from OHCA should be transported in a cardiac centre with PCI readiness on a 24/7 basis.

Keywords: sudden cardiac arrest, resuscitation, out-of-hospital cardiac arrest, young adults, mild therapeutic hypothermia