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The association of early diarrhea after successful resuscitation following out-of-hospital cardiac arrest with neurological outcome: A retrospective observational study.
Schriefl, Christoph; Steininger, Philipp; Clodi, Christian; Mueller, Matthias; Poppe, Michael; Ettl, Florian; Nuernberger, Alexander; Grafeneder, Juergen; Losert, Heidrun; Schwameis, Michael; Holzer, Michael; Sterz, Fritz; Schoergenhofer, Christian.
Affiliation
  • Schriefl C; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
  • Steininger P; Emergency Department, Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria.
  • Clodi C; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
  • Mueller M; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
  • Poppe M; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
  • Ettl F; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
  • Nuernberger A; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
  • Grafeneder J; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
  • Losert H; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
  • Schwameis M; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
  • Holzer M; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
  • Sterz F; Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
  • Schoergenhofer C; Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Medicine (Baltimore) ; 100(49): e28164, 2021 Dec 10.
Article in En | MEDLINE | ID: mdl-34889287
ABSTRACT: Gastrointestinal ischemia with reperfusion tissue injury contributes to post-cardiac arrest syndrome. We hypothesized that diarrhea is a symptom of intestinal ischemia/reperfusion injury and investigated whether the occurrence of early diarrhea (≤12 hours) after successful cardiopulmonary resuscitation is associated with an unfavorable neurological outcome.We analyzed data from the Vienna Clinical Cardiac Arrest Registry. Inclusion criteria comprised ≥18 years of age, a witnessed, non-traumatic out-of-hospital cardiac arrest, return of spontaneous circulation (ROSC), initial shockable rhythm, and ST-segment elevation in electrocardiogram after ROSC with consecutive coronary angiography. Patients with diarrhea caused by other factors (e.g., infections, antibiotic treatment, or chronic diseases) were excluded. The primary endpoint was neurological function between patients with or without "early diarrhea" (≤12 hours after ROSC) according to cerebral performance categories.We included 156 patients between 2005 and 2012. The rate of unfavorable neurologic outcome was higher in patients with early diarrhea (67% vs 37%). In univariate analysis, the crude odds ratio for unfavorable neurologic outcome was 3.42 (95% confidence interval, 1.11-10.56, P = .03) for early diarrhea. After multivariate adjustment for traditional prognostication markers the odds ratio of early diarrhea was 5.90 (95% confidence interval, 1.28-27.06, P = .02).In conclusion, early diarrhea within 12 hours after successful cardiopulmonary resuscitation was associated with an unfavorable neurological outcome.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiopulmonary Resuscitation / Diarrhea / Out-of-Hospital Cardiac Arrest Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Medicine (Baltimore) Year: 2021 Document type: Article Affiliation country: Country of publication:

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Cardiopulmonary Resuscitation / Diarrhea / Out-of-Hospital Cardiac Arrest Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Medicine (Baltimore) Year: 2021 Document type: Article Affiliation country: Country of publication: