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Cardiorenal function and survival in in-hospital cardiac arrest: A nationwide study of 22,819 cases
Univ Gothenburg, Inst Med, Dept Mol & Clin Med, Gothenburg, Sweden.
Univ Gothenburg, Inst Med, Dept Mol & Clin Med, Gothenburg, Sweden.
Univ Gothenburg, Inst Med, Dept Mol & Clin Med, Gothenburg, Sweden.
Univ Gothenburg, Inst Med, Dept Mol & Clin Med, Gothenburg, Sweden.
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2022 (English)In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 172, p. 9-16Article in journal (Refereed) Published
Abstract [en]

Background: We studied the association between cardiorenal function and survival, neurological outcome and trends in survival after in-hospital Methods: We included cases aged 18 years in the Swedish Cardiopulmonary Resuscitation Registry during 2008 to 2020. The CKD-EPI equation was used to calculate estimated glomerular filtration rate (eGFR). A history of heart failure was defined according to contemporary guideline criteria. Logistic regression was used to study survival. Neurological outcome was assessed using cerebral performance category (CPC). Results: We studied 22,819 patients with IHCA. The 30-day survival was 19.3%, 16.6%, 22.5%, 28.8%, 39.3%, 44.8% and 38.4% in cases with eGFR < 15, 15-29, 30-44, 45-59, 60-89, 90-130 and 130-150 ml/min/1.73 m2, respectively. All eGFR levels below and above 90 ml/min/1.73 m2 were associated with increased mortality. Probability of survival at 30 days was 62% lower in cases with eGFR < 15 ml/min/1.73 m2, compared with normal kidney function. At every level of eGFR, presence of heart failure increased mortality markedly; patients without heart failure displayed higher mortality only at eGFR below 30 ml/min/1.73 m2. Among survivors with eGFR < 15 ml/min/1.73 m2, good neurological outcome was noted in 87.2%. Survival increased in most groups over time, but most for those with eGFR < 15 ml/min/1.73 m2, and least for those with normal eGFR. Conclusions: All eGFR levels below and above normal range are associated with increased mortality and this association is modified by the presence of heart failure. Neurological outcome is good in the majority of cases, across kidney function levels and survival is increasing.

Place, publisher, year, edition, pages
2022. Vol. 172, p. 9-16
Keywords [en]
In-hospital cardiac arrest, Kidney function, Renal disease, Heart failure, CHRONIC KIDNEY-DISEASE, STAGE RENAL-DISEASE, GLOMERULAR HYPERFILTRATION, CARDIOVASCULAR-DISEASE, MECHANISMS, EPIDEMIOLOGY, CALCIFICATION, OUTCOMES, DECLINE, IMPACT
National Category
Cardiac and Cardiovascular Systems
Research subject
The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-27710DOI: 10.1016/j.resuscitation.2021.12.037ISI: 000767379900002PubMedID: 35031390Scopus ID: 2-s2.0-85123358298OAI: oai:DiVA.org:hb-27710DiVA, id: diva2:1648585
Funder
Swedish Research Council, 2019-02019
Note

Times Cited in Web of Science Core Collection: 0 Total Times Cited: 0 Cited Reference Count: 27

Available from: 2022-03-31 Created: 2022-03-31 Last updated: 2023-01-18Bibliographically approved

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Herlitz, Johan

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