Glucocorticoid use during cardiopulmonary resuscitation may be beneficial for cardiac arrest

Min Shan Tsai, Po Ya Chuang, Ping Hsun Yu, Chien Hua Huang, Chao Hsiun Tang, Wei Tien Chang, Wen Jone Chen

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Various studies have indicated that glucocorticoid supplementation during cardiopulmonary resuscitation (CPR), in conjunction with vasopressors, may improve outcomes in instances of cardiac arrest. However, further population-based analysis is warranted with respect to resuscitative and long-term survival benefits conferred by administering glucocorticoids in this setting. Methods A total of 145,644 adult patients who experienced non-traumatic, cardiac arrest occurred at emergency room during years 2004–2011 were selected for study from the Taiwan National Health Insurance Research database. These patients were grouped as steroid and non-steroid recipients during CPR, and group members were matched in terms of patient characteristics, including presenting complaint, prior steroid use, resuscitative drugs and shocks delivered, treatment setting (medical center or not), socioeconomic status, and year that cardiac arrest occurred, through propensity scoring. Logistic regression analysis was performed to determine the impact of steroid usage on survival to admission, survival to discharge, and 1-year survival. Results Compared with matched non-steroid group members (n = 8628), patients given steroid (n = 2876) displayed significantly higher rates of survival to admission (38.32% vs 18.67%; adjusted OR = 2.97, 95% CI 2.69–3.29; p < 0.0001), survival to discharge (14.50% vs 5.61%; adjusted OR = 1.71, 95% CI 1.42–2.05; p < 0.0001), and 1-year overall survival (10.81% vs 4.74%; adjusted OR = 1.48, 95% CI 1.22–1.79; p < 0.0001). Steroid use proved more beneficial in patients with COPD or asthma and in the absence of shockable rhythm during CPR. Conclusion Glucocorticoid use during CPR is associated with improved survival-to-admission, survival-to-discharge, and 1-year survival rates.

Original languageEnglish
Pages (from-to)629-635
Number of pages7
JournalInternational Journal of Cardiology
Volume222
DOIs
Publication statusPublished - Nov 1 2016

Fingerprint

Cardiopulmonary Resuscitation
Heart Arrest
Glucocorticoids
Survival
Steroids
Survival Rate
National Health Programs
Taiwan
Social Class
Chronic Obstructive Pulmonary Disease
Hospital Emergency Service
Shock
Asthma
Logistic Models
Regression Analysis
Databases
Research
Pharmaceutical Preparations
Population

Keywords

  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Glucocorticoid
  • Propensity score
  • Survival
  • Taiwan National Health Insurance Research database

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

Glucocorticoid use during cardiopulmonary resuscitation may be beneficial for cardiac arrest. / Tsai, Min Shan; Chuang, Po Ya; Yu, Ping Hsun; Huang, Chien Hua; Tang, Chao Hsiun; Chang, Wei Tien; Chen, Wen Jone.

In: International Journal of Cardiology, Vol. 222, 01.11.2016, p. 629-635.

Research output: Contribution to journalArticle

Tsai, Min Shan ; Chuang, Po Ya ; Yu, Ping Hsun ; Huang, Chien Hua ; Tang, Chao Hsiun ; Chang, Wei Tien ; Chen, Wen Jone. / Glucocorticoid use during cardiopulmonary resuscitation may be beneficial for cardiac arrest. In: International Journal of Cardiology. 2016 ; Vol. 222. pp. 629-635.
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abstract = "Background Various studies have indicated that glucocorticoid supplementation during cardiopulmonary resuscitation (CPR), in conjunction with vasopressors, may improve outcomes in instances of cardiac arrest. However, further population-based analysis is warranted with respect to resuscitative and long-term survival benefits conferred by administering glucocorticoids in this setting. Methods A total of 145,644 adult patients who experienced non-traumatic, cardiac arrest occurred at emergency room during years 2004–2011 were selected for study from the Taiwan National Health Insurance Research database. These patients were grouped as steroid and non-steroid recipients during CPR, and group members were matched in terms of patient characteristics, including presenting complaint, prior steroid use, resuscitative drugs and shocks delivered, treatment setting (medical center or not), socioeconomic status, and year that cardiac arrest occurred, through propensity scoring. Logistic regression analysis was performed to determine the impact of steroid usage on survival to admission, survival to discharge, and 1-year survival. Results Compared with matched non-steroid group members (n = 8628), patients given steroid (n = 2876) displayed significantly higher rates of survival to admission (38.32{\%} vs 18.67{\%}; adjusted OR = 2.97, 95{\%} CI 2.69–3.29; p < 0.0001), survival to discharge (14.50{\%} vs 5.61{\%}; adjusted OR = 1.71, 95{\%} CI 1.42–2.05; p < 0.0001), and 1-year overall survival (10.81{\%} vs 4.74{\%}; adjusted OR = 1.48, 95{\%} CI 1.22–1.79; p < 0.0001). Steroid use proved more beneficial in patients with COPD or asthma and in the absence of shockable rhythm during CPR. Conclusion Glucocorticoid use during CPR is associated with improved survival-to-admission, survival-to-discharge, and 1-year survival rates.",
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AU - Chuang, Po Ya

AU - Yu, Ping Hsun

AU - Huang, Chien Hua

AU - Tang, Chao Hsiun

AU - Chang, Wei Tien

AU - Chen, Wen Jone

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AB - Background Various studies have indicated that glucocorticoid supplementation during cardiopulmonary resuscitation (CPR), in conjunction with vasopressors, may improve outcomes in instances of cardiac arrest. However, further population-based analysis is warranted with respect to resuscitative and long-term survival benefits conferred by administering glucocorticoids in this setting. Methods A total of 145,644 adult patients who experienced non-traumatic, cardiac arrest occurred at emergency room during years 2004–2011 were selected for study from the Taiwan National Health Insurance Research database. These patients were grouped as steroid and non-steroid recipients during CPR, and group members were matched in terms of patient characteristics, including presenting complaint, prior steroid use, resuscitative drugs and shocks delivered, treatment setting (medical center or not), socioeconomic status, and year that cardiac arrest occurred, through propensity scoring. Logistic regression analysis was performed to determine the impact of steroid usage on survival to admission, survival to discharge, and 1-year survival. Results Compared with matched non-steroid group members (n = 8628), patients given steroid (n = 2876) displayed significantly higher rates of survival to admission (38.32% vs 18.67%; adjusted OR = 2.97, 95% CI 2.69–3.29; p < 0.0001), survival to discharge (14.50% vs 5.61%; adjusted OR = 1.71, 95% CI 1.42–2.05; p < 0.0001), and 1-year overall survival (10.81% vs 4.74%; adjusted OR = 1.48, 95% CI 1.22–1.79; p < 0.0001). Steroid use proved more beneficial in patients with COPD or asthma and in the absence of shockable rhythm during CPR. Conclusion Glucocorticoid use during CPR is associated with improved survival-to-admission, survival-to-discharge, and 1-year survival rates.

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KW - Cardiopulmonary resuscitation

KW - Glucocorticoid

KW - Propensity score

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