Impact of fibrinolysis on immediate prognosis of patients with out-of-hospital cardiac arrest

Aurélien Renard, Catherine Verret, Daniel Jost, Jean Baptiste Meynard, Julie Tricehreau, Olivier Hersan, David Fontaine, Frédérique Briche, Patrick Benner, Olivier De Stabenrath, Christophe Bartou, Nicolas Segal, Laurent Domanski

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7 Scopus citations

Abstract

Fibrinolytic therapy (FT) during out-of-hospital cardiac arrest (OHCA) has been studied in several trials, but they have produced unsatisfactory results even in the most recent Thrombolysis in Cardiac Arrest (TROICA) study. This study aimed to assess the impact of FT provided by an out-of-hospital emergency physician on the immediate prognosis of patients with OHCA. We performed a retrospective study in which the primary endpoint was survival to hospital admission. Among 5,102 patients with OHCA in Paris and the suburban area who received medical care from the Fire Brigade of Paris, 1,261 met the following inclusion criteria: age above 18 years with nontraumatic OHCA. Among 107 patients who received FT, 51 (47.7%) survived to hospital admission whereas 272 out of 1,154 (23.6%) patients who did not receive FT survived to hospital admission. A matching process based on a propensity score used to equalise potential prognosis factors in both groups demonstrated that FT was associated with more frequent survival to hospital admission (OR adjusted: 1.7; CI 95% [1.09-2.68]). This result was observed particularly in patients who were not initially shocked by automatic electrical defibrillator (AED) (OR a = 3.61; CI 95% [1.88-6.96]). This study showed that fibrinolysis was associated with improved survival to hospital admission, after performing a propensity analysis. FT may be beneficial in out-of-hospital arrest patients. However, any conclusions drawn are limited by the retrospective nature of the study.

Original languageEnglish (US)
Pages (from-to)405-409
Number of pages5
JournalJournal of thrombosis and thrombolysis
Volume32
Issue number4
DOIs
StatePublished - Nov 1 2011

Keywords

  • Cardiac arrest
  • Fibrinolysis
  • Pre-hospital care
  • Resuscitation

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