Zhang W, et al. - Researchers focused on out-of-hospital cardiac arrest (OHCA) patients with Do-Not-Resuscitate orders signed in the hospital who survived to hospital discharge or recovered with favorable neurological function in order to describe their clinical features and factors associated with better outcomes. Factors associated with better outcomes in this study were witnessed arrest, prehospital shock delivered, Return of Spontaneous Circulation (ROSC) obtained in the field, cardiovascular interventions or procedures applied, and no prehospital adrenaline administered. They recommended considering these factors before Do-Not-Resuscitate decisions are made in hospital for those admitted OHCA patients.

Methods

• Researchers performed a retrospective, observational analysis of all adult non-traumatic OHCA who were enrolled in the Resuscitation
• Demographics, characteristics, interventions and outcomes of all enrolled cases were reported.
• Comparison was performed of patients surviving and not surviving to hospital discharge, as well as of those who did and did not obtain favorable neurological recovery.
• Factors which might be prognostic to survival and favorable neurological outcomes at discharge were assessed using logistic regression models.

Results

• Researchers identified 2,289 admitted patients with Do-Not-Resuscitate order signed in hospital.
• Out of these, 132 (5.8%) survived to hospital discharge and 28 (1.2%) achieved favorable neurological recovery.
• Factors, including witnessed arrest, prehospital shock delivered, Return of Spontaneous Circulation (ROSC) obtained in the field, cardiovascular interventions or procedures applied, and no prehospital adrenaline administered, were observed to have independent association with better outcomes.