Publication
Cardiac arrest caused by acute intoxication-insight from a registry
Journal Paper/Review - Sep 7, 2013
Hörburger David, Weiser Christoph, Testori Christoph, Uray Thomas, Stratil Peter, Stöckl Mathias, Schober Andres, Sterz Fritz, Kurkciyan Istepan, Haugk Moritz
Units
PubMed
Doi
Citation
Type
Journal
Publication Date
Issn Electronic
Pages
Brief description/objective
INTRODUCTION
The aim of the study was to evaluate the epidemiology and outcome after cardiac arrest caused by intoxication.
METHODS
A retrospective analysis of 1991 to 2010 medical record of patients experiencing cardiac arrest caused by self-inflicted, intentional intoxication was performed. The setting was an emergency department of a tertiary care university hospital. The primary end point was the presentation of epidemiologic data in relation to favorable neurologic outcome, defined as cerebral performance categories 1 or 2 and 180-day survival. Furthermore, the patients were subdivided into a single-substance and polysubstance group, depending on the substances causing the intoxication.
RESULTS
Of 3644 patients admitted to our department, 99 (2.7%) with a median age of 26 (interquartile range, 19-42) years (37% female) were included. Cardiac arrest was witnessed in 62 cases (63%). Eleven patients (11%) received basic life support by bystanders, and 11 (11%) had a shockable rhythm in the initial electrocardiogram. The combined end point "good survival" was achieved by 34 patients (34%). Cardiac arrest occurred out of hospital in 73 patients (74%) and in-hospital in 26 patients (26%). A single substance causing the intoxication was found in 56 patients (56%). Opiates were the leading substance, with 25 patients (25%) using them.
CONCLUSION
Cardiac arrest caused by intoxication is found predominately in young patients. Overall, favorable neurologic survival was achieved in 34%. Opiate-related cardiac arrest was associated with poor survival and a high incidence of neurologic deficits.