You searched for:"Sara Pereira"
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Original Article
Predictors of coronary artery disease in cardiac arrest survivors: coronary angiography for everyone? A single-center retrospective analysis
Rev Bras Ter Intensiva. 2021;33(2):251-260
Abstract
Original ArticlePredictors of coronary artery disease in cardiac arrest survivors: coronary angiography for everyone? A single-center retrospective analysis
Rev Bras Ter Intensiva. 2021;33(2):251-260
DOI 10.5935/0103-507X.20210032
Views0ABSTRACT
Objective:
To identify predictors of coronary artery disease in survivors of cardiac arrest, to define the best timing for coronary angiography and to establish the relationship between coronary artery disease and mortality.
Methods:
This was a single-center retrospective study including consecutive patients who underwent coronary angiography after cardiac arrest.
Results:
A total of 117 patients (63 ± 13 years, 77% men) were included. Most cardiac arrest incidents occurred with shockable rhythms (70.1%), and the median duration until the return of spontaneous circulation was 10 minutes. Significant coronary artery disease was found in 68.4% of patients, of whom 75% underwent percutaneous coronary intervention. ST-segment elevation (OR 6.5, 95%CI 2.2 – 19.6; p = 0.001), the presence of wall motion abnormalities (OR 22.0, 95%CI 5.7 – 84.6; p < 0.001), an left ventricular ejection fraction ≤ 40% (OR 6.2, 95%CI 1.8 - 21.8; p = 0.005) and elevated high sensitivity troponin T (OR 3.04, 95%CI 1.3 - 6.9; p = 0.008) were predictors of coronary artery disease; the latter had poor accuracy (area under the curve 0.64; p = 0.004), with an optimal cutoff of 170ng/L. Only ST-segment elevation and the presence of wall motion abnormalities were independent predictors of coronary artery disease. The duration of cardiac arrest (OR 1.015, 95%CI 1.0 - 1.05; p = 0.048) was an independent predictor of death, and shockable rhythm (OR 0.4, 95%CI 0.4 - 0.9; p = 0.031) was an independent predictor of survival. The presence of coronary artery disease and the performance of percutaneous coronary intervention had no impact on survival; it was not possible to establish the best cutoff for coronary angiography timing.
Conclusion:
In patients with cardiac arrest, ST-segment elevation, wall motion abnormalities, left ventricular dysfunction and elevated high sensitivity troponin T were predictive of coronary artery disease. Neither coronary artery disease nor percutaneous coronary intervention significantly impacted survival.
Keywords:Cardiac ArrestCoronary angiographyCoronary artery diseasepercutaneous coronary interventionSurvivalSee more -
Original Articles
Long-term psychological outcome after discharge from intensive care
Rev Bras Ter Intensiva. 2018;30(1):28-34
Abstract
Original ArticlesLong-term psychological outcome after discharge from intensive care
Rev Bras Ter Intensiva. 2018;30(1):28-34
DOI 10.5935/0103-507X.20180008
Views0ABSTRACT
Objective:
To investigate the longterm psychological outcome in survivors of critical illness after intensive care unit discharge.
Methods:
A prospective cohort of survivors admitted to a mixed intensive care unit between January and September 2010 was evaluated six months and five years after hospital discharge. The Dementia Rating Scale-2, the Hospital Anxiety and Depression Scale, the Posttraumatic stress syndrome 14-questions inventory, the Euro Quality of Life 5 Dimensions (EQ-5-D), and the Visual Analogue Scale (EQ VAS) were assessed at both follow-up periods.
Results:
Of 267 patients, 25 patients were evaluated at 6 months after discharge (62 ± 16 years); 12 (48%) presented cognitive impairment, 6 (24%) anxiety, 4 (16%) depression, and 4 (16%) post-traumatic stress disorder. Among those re-evaluated five years after discharge (n = 17; 65 ± 15 years), the frequency of cognitive impairment dropped from 8 (47%) to 3 (18%) (p = 0.063), due to improvement in these patients over time, and other patients did not acquire any dysfunction after discharge. At five years after discharge, only two patients (12%) reported anxiety, and none had depression or post-traumatic stress disorder. No differences were found between the six-month and five-year follow-ups regarding EQ-5-D and EQ VAS.
Conclusion:
Survivors do not show a progressive decline in cognitive function or quality of life within five years after intensive care unit discharge. Psychopathological symptoms tend to decrease with time.
Keywords:AnxietyCognitive dysfunctionDepressionIntensive care unitsPatient dischargeQuality of lifeStress disorders, post-traumaticSee more
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