Cardiovascular risk factors differently affect the survival of patients undergoing manual or mechanical resuscitation

Background

Chest compression is a decisive element of cardio-pulmonary resuscitation (CPR). By applying a mechanical CPR device, compression interruptions can be minimised. We examined the efficiency of manual and device-assisted resuscitation as well as the effects of cardiovascular risk factors on the outcome of resuscitation.

Methods

In our retrospective, randomised 3-year study the data of adult patients suffering non-traumatic, out-of-hospital, sudden cardiac death (SCD) were analysed (n?=?287). The data were retrieved by processing case reports, Utstein sheets and acute coronary syndrome sheets. We compared the data of patients undergoing manual (n?=?232) and device-assisted resuscitation (LUCAS-2, n?=?55). The primary endpoint was the on-site restoration of spontaneous circulation (ROSC).

Results and conclusion

In 37% of the cases ROSC happened. With respect to ROSC an insignificantly more favourable tendency was demonstrated in the case of device-assisted resuscitation (p =?0.072). In the Lucas group, a higher success rate occurred even in the case of prolonged resuscitation. We found a better outcome in the Lucas group in the case of CPR started a longer time after the SCD (p?<?0.05). A positive correlation was established between age and unsuccessful resuscitation (p?=?<?0.017; r?=?0.125). An unfavourable correlation was observed between hypertension and the outcome of resuscitation (p?=?0.018; r?=?0.143). According to our results the presence of left ventricular hypertrophy poses 5.1-fold risk of unsuccessful CPR (CI: 4.97–5.29).Advanced age and structural heart diseases can play a role in the genesis of SCD. Importantly, left ventricular hypertrophy and hypertension negatively affect survival.