Table 2.
ICU course and complications of propensity score-matched cohorts.
| OHCA | OHCA + AMI–rCS | |||||
|---|---|---|---|---|---|---|
| Variable | Without CS, | + AMI–rCS | P | + Impella, | Without Impella, | P |
| n = 90 |
+ Impella,
n = 47 |
n = 15 | n = 15 | |||
| Bystander CPR performed | 68 (75.6%) | 37 (78.7%) | ns | 11 (73.3%) | 10 (66.7%) | ns |
| Witnessed arrest | 79 (87.7%) | 39 (83%) | ns | 14 (93.3%) | 14 (93.3%) | ns |
| ongoing CPR at admission | 5 (5.6%) | 6 (65.4%) | ns | 0 | 0 | |
| Out of hospital defibrillation (n) | 2.9 ± 2.5 | 3.5 ± 2.9 | ns | 3.8 ± 3.8 | 3.7 ± 2.1 | ns |
| Primary rhythm | ns | ns | ||||
| Asystole | 18 (20%) | 6 (12.8%) | 1 (6.7%) | 2 (13.3%) | ||
| Ventricular Fibrillation | 72 (80%) | 41 (87.2%) | 14 (93.3%) | 13 (86.7%) | ||
| Time intervals | ||||||
| ROSC (min) | 18 (10–30) | 23 (10–31) | ns | 20 (10–30) | 25 (10–35) | ns |
| Duration puncture to wire crossing (min) | 14.3 ± 7.1 | 24.3 ± 9.9 | <0.001 | 21.5 ± 9.9 | 17.7 ± 5.2 | ns |
| Shock onset to Impella (h) | 3 (1.5–4) | 3 (2–4) | ||||
| Duration of Impella support (h) | 89 (46–156) | 90 (46–216) | ||||
| Impella implantation | ||||||
| Pre-PCI | 28 (59.6%) | 8 (53.3%) | ||||
| Post-PCI | 19 (40.4%) | 7 (46.7%) | ||||
| LVEDP at the time of PCI | 19 ± 6.3 (n = 78) | 26.7 ± 6.7 | <0.001 | 25.5 ± 4.6 | 25.3 ± 4.5 | ns |
| Bridge to | ||||||
| Deceased during LV support | 12 (25.5%) | 3 (20%) | ||||
| Recovery | 34 (72.3%) | 12 (80%) | ||||
| Durable VAD | 1 (2.1%) | 0 | ||||
| RRT during ICU stay | 17 (18.9%) | 17 (36.2%) | 0.026 | 6 (40%) | 1 (6.7%) | 0.031 |
| Hemolysis | 0 | 16 (34%) | <0.001 | 4 (26.7%) | 0 | 0.032 |
| Peripheral ischemic complications forcing vascular surgery or intervention | 2 (2.2%) | 4 (8.5%) | ns | 1 (6.7%) | 1 (6.7%) | ns |
| Good neurological outcome after 30 days (CPC ≤2) | 40 (44%) | 24 (51%) | ns | 7 (47%) | 4 (27%) | ns |
| GUSTO bleeding | 0.014 | 0.039 | ||||
| Mild | 12 (13.3%) | 14 (29.8%) | 4 (27%) | 2 (13%) | ||
| Moderate | 4 (4.4%) | 5 (10.6%) | 4 (27%) | 0 | ||
| Severe | 0 | 1 (2.1%) | 0 | 0 | ||
AMI, acute myocardial infarction; CPC, cerebral performance category; CPR, cardio-pulmonary resuscitation; ICU, intensive care unit; LV, left ventricular; LVEDP, left ventricular end diastolic pressure; PCI, percutaneous coronary intervention; rCS, refractory cardiogenic shock; ROSC, return of spontaneous circulation; RRT, renal replacement therapy; VAD, ventricular assist device.