Infections in the survivors of out-of-hospital cardiac arrest in the first 7 days

Min Shan Tsai, Wen Chu Chiang, Chien Chang Lee, Cheng Chun Hsieh, Patrick Chow In Ko, Chiung Yuan Hsu, Chan Ping Su, Shey Ying Chen, Wei Tein Chang, Ang Yuan, Matthew Huei Ming Ma, Shyr Chyr Chen, Wen Jone Chen

Research output: Contribution to journalArticle

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Abstract

Objective: To evaluate the incidence, risk factors, foci, isolated organisms, and outcomes of infections in the survivors of out-of-hospital cardiac arrest (OHCA) within the first 7 days after resuscitation. Design and setting: Retrospective cohort study in the intensive care unit of a university hospital. Patients and participants: We enrolled 117 survivors of adult nontraumatic OHCA victims who survived more than 24 h between January 1999 and May 2004. We collected patients' demographics, the causes and initial electrocardiographic rhythm of cardiac arrest, and the process of cardiopulmonary resuscitation. The incidence, clinical presentations and outcomes of infections occurring in the first 7 days after resuscitation were evaluated. Variables were compared between the infected and noninfected patients. Measurements and results: Among our OHCA survivors asystole was the most common initial rhythm (66%). Eighty-three patients (71%) were found to have infection. Pneumonia was the most common infection (61%) followed by bacteremia (13%). Although the Gram-negative bacteria were responsible for most infections, the most commonly isolated organism was Staphylococcus aureus. The infection group had more patients with dementia and noncardiac causes of OHCA. The survival curves did not differ significantly between infection and noninfection groups. Conclusions: Infections were common in OHCA survivors during the first 7 days. The most common responsible organisms were Gram-negative bacteria, and the most commonly isolated organism was S. aureus. Infections in the early stage after return of spontaneous circulation did not change the hospital mortality and hospitalization duration.

Original languageEnglish
Pages (from-to)621-626
Number of pages6
JournalIntensive Care Medicine
Volume31
Issue number5
DOIs
Publication statusPublished - May 1 2005
Externally publishedYes

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Out-of-Hospital Cardiac Arrest
Survivors
Infection
Heart Arrest
Gram-Negative Bacteria
Resuscitation
Staphylococcus aureus
Incidence
Cardiopulmonary Resuscitation
Bacteremia
Hospital Mortality
Intensive Care Units
Dementia
Pneumonia
Hospitalization
Cohort Studies
Retrospective Studies
Demography

Keywords

  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Pneumonia, bacteremia
  • Return of spontaneous circulation
  • Staphylococcus aureus

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Tsai, M. S., Chiang, W. C., Lee, C. C., Hsieh, C. C., Ko, P. C. I., Hsu, C. Y., ... Chen, W. J. (2005). Infections in the survivors of out-of-hospital cardiac arrest in the first 7 days. Intensive Care Medicine, 31(5), 621-626. https://doi.org/10.1007/s00134-005-2612-6

Infections in the survivors of out-of-hospital cardiac arrest in the first 7 days. / Tsai, Min Shan; Chiang, Wen Chu; Lee, Chien Chang; Hsieh, Cheng Chun; Ko, Patrick Chow In; Hsu, Chiung Yuan; Su, Chan Ping; Chen, Shey Ying; Chang, Wei Tein; Yuan, Ang; Ma, Matthew Huei Ming; Chen, Shyr Chyr; Chen, Wen Jone.

In: Intensive Care Medicine, Vol. 31, No. 5, 01.05.2005, p. 621-626.

Research output: Contribution to journalArticle

Tsai, MS, Chiang, WC, Lee, CC, Hsieh, CC, Ko, PCI, Hsu, CY, Su, CP, Chen, SY, Chang, WT, Yuan, A, Ma, MHM, Chen, SC & Chen, WJ 2005, 'Infections in the survivors of out-of-hospital cardiac arrest in the first 7 days', Intensive Care Medicine, vol. 31, no. 5, pp. 621-626. https://doi.org/10.1007/s00134-005-2612-6
Tsai, Min Shan ; Chiang, Wen Chu ; Lee, Chien Chang ; Hsieh, Cheng Chun ; Ko, Patrick Chow In ; Hsu, Chiung Yuan ; Su, Chan Ping ; Chen, Shey Ying ; Chang, Wei Tein ; Yuan, Ang ; Ma, Matthew Huei Ming ; Chen, Shyr Chyr ; Chen, Wen Jone. / Infections in the survivors of out-of-hospital cardiac arrest in the first 7 days. In: Intensive Care Medicine. 2005 ; Vol. 31, No. 5. pp. 621-626.
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abstract = "Objective: To evaluate the incidence, risk factors, foci, isolated organisms, and outcomes of infections in the survivors of out-of-hospital cardiac arrest (OHCA) within the first 7 days after resuscitation. Design and setting: Retrospective cohort study in the intensive care unit of a university hospital. Patients and participants: We enrolled 117 survivors of adult nontraumatic OHCA victims who survived more than 24 h between January 1999 and May 2004. We collected patients' demographics, the causes and initial electrocardiographic rhythm of cardiac arrest, and the process of cardiopulmonary resuscitation. The incidence, clinical presentations and outcomes of infections occurring in the first 7 days after resuscitation were evaluated. Variables were compared between the infected and noninfected patients. Measurements and results: Among our OHCA survivors asystole was the most common initial rhythm (66{\%}). Eighty-three patients (71{\%}) were found to have infection. Pneumonia was the most common infection (61{\%}) followed by bacteremia (13{\%}). Although the Gram-negative bacteria were responsible for most infections, the most commonly isolated organism was Staphylococcus aureus. The infection group had more patients with dementia and noncardiac causes of OHCA. The survival curves did not differ significantly between infection and noninfection groups. Conclusions: Infections were common in OHCA survivors during the first 7 days. The most common responsible organisms were Gram-negative bacteria, and the most commonly isolated organism was S. aureus. Infections in the early stage after return of spontaneous circulation did not change the hospital mortality and hospitalization duration.",
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AU - Ko, Patrick Chow In

AU - Hsu, Chiung Yuan

AU - Su, Chan Ping

AU - Chen, Shey Ying

AU - Chang, Wei Tein

AU - Yuan, Ang

AU - Ma, Matthew Huei Ming

AU - Chen, Shyr Chyr

AU - Chen, Wen Jone

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N2 - Objective: To evaluate the incidence, risk factors, foci, isolated organisms, and outcomes of infections in the survivors of out-of-hospital cardiac arrest (OHCA) within the first 7 days after resuscitation. Design and setting: Retrospective cohort study in the intensive care unit of a university hospital. Patients and participants: We enrolled 117 survivors of adult nontraumatic OHCA victims who survived more than 24 h between January 1999 and May 2004. We collected patients' demographics, the causes and initial electrocardiographic rhythm of cardiac arrest, and the process of cardiopulmonary resuscitation. The incidence, clinical presentations and outcomes of infections occurring in the first 7 days after resuscitation were evaluated. Variables were compared between the infected and noninfected patients. Measurements and results: Among our OHCA survivors asystole was the most common initial rhythm (66%). Eighty-three patients (71%) were found to have infection. Pneumonia was the most common infection (61%) followed by bacteremia (13%). Although the Gram-negative bacteria were responsible for most infections, the most commonly isolated organism was Staphylococcus aureus. The infection group had more patients with dementia and noncardiac causes of OHCA. The survival curves did not differ significantly between infection and noninfection groups. Conclusions: Infections were common in OHCA survivors during the first 7 days. The most common responsible organisms were Gram-negative bacteria, and the most commonly isolated organism was S. aureus. Infections in the early stage after return of spontaneous circulation did not change the hospital mortality and hospitalization duration.

AB - Objective: To evaluate the incidence, risk factors, foci, isolated organisms, and outcomes of infections in the survivors of out-of-hospital cardiac arrest (OHCA) within the first 7 days after resuscitation. Design and setting: Retrospective cohort study in the intensive care unit of a university hospital. Patients and participants: We enrolled 117 survivors of adult nontraumatic OHCA victims who survived more than 24 h between January 1999 and May 2004. We collected patients' demographics, the causes and initial electrocardiographic rhythm of cardiac arrest, and the process of cardiopulmonary resuscitation. The incidence, clinical presentations and outcomes of infections occurring in the first 7 days after resuscitation were evaluated. Variables were compared between the infected and noninfected patients. Measurements and results: Among our OHCA survivors asystole was the most common initial rhythm (66%). Eighty-three patients (71%) were found to have infection. Pneumonia was the most common infection (61%) followed by bacteremia (13%). Although the Gram-negative bacteria were responsible for most infections, the most commonly isolated organism was Staphylococcus aureus. The infection group had more patients with dementia and noncardiac causes of OHCA. The survival curves did not differ significantly between infection and noninfection groups. Conclusions: Infections were common in OHCA survivors during the first 7 days. The most common responsible organisms were Gram-negative bacteria, and the most commonly isolated organism was S. aureus. Infections in the early stage after return of spontaneous circulation did not change the hospital mortality and hospitalization duration.

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KW - Cardiopulmonary resuscitation

KW - Pneumonia, bacteremia

KW - Return of spontaneous circulation

KW - Staphylococcus aureus

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