Korean J Crit Care Med.  2011 Sep;26(3):151-156. 10.4266/kjccm.2011.26.3.151.

A Retrospective Study about Characteristics of Out-of-hospital Cardiac Arrest Caused by Non-traumatic Subarachnoid Hemorrhage

• Sim MS
• Sung KD
• Kang MJ
• Na JU
• Shin TG
• Jo IJ
• Song HG
• Song KJ
• Jeong YK

• KMID: 2228092
• DOI: http://doi.org/10.4266/kjccm.2011.26.3.151

Abstract

BACKGROUND
Subarachnoid hemorrhage is a fatal disease relatively common in the East Asian population. It can lead to cardiac arrest in several pathologic processes. We attempted to elucidate the characteristics of out-of-hospital cardiac arrest caused by non-traumatic subarachnoid hemorrhage.
METHODS
We conducted a retrospective, observational study in which patients who had visited Samsung medical center emergency room for out-of-hospital cardiac arrest from January, 1999 to December 2008 were enrolled. A total of 218 OHCA patients who had achieved ROSC were investigated by review of medical charts. Excluding those who had worn trauma, we analyzed 22 patients who had been diagnosed for SAH by brain non-contrast CT scan.
RESULTS
Median age of aneurysmal SAH-induced OHCA patients was 61 (IQR 54-67) years. Fourteen patients (64%) were female and 15 patients (68%) were witnessed. Besides, 7 patients (32%) had complained of headache before collapse. We also found 11 patients (50%) had been diagnosed with hypertension previously. All of them showed unshockable rhythm (asystole 60%, PEA 40%) initially. Their median duration of ACLS was 10 minutes. Majority of patients died within 24 hours and survivors showed poor neurologic outcome.
CONCLUSIONS
Subarachnoid hemorrhage is a relatively uncommon cause of cardiac arrest, and the outcome of OHCA induced by SAH is very poor. However, emergency physicians have to consider the possibility of SAH when trying to determine the cause of arrest, especially when treating patients who have the characteristics described above.

Keyword

subarachnoid hemorrhage; out-of-hospital cardiac arrest

MeSH Terms

Aneurysm
Asian Continental Ancestry Group
Brain
Emergencies
Female
Headache
Heart Arrest
Humans
Hypertension
Out-of-Hospital Cardiac Arrest
Pathologic Processes
Peas
Retrospective Studies
Subarachnoid Hemorrhage
Survivors
Wit and Humor as Topic