Intensive Care Medicine

, Volume 40, Issue 6, pp 846–854 | Cite as

Characteristics and prognosis of sudden cardiac death in Greater Paris

Population-based approach from the Paris Sudden Death Expertise Center (Paris—SDEC)
  • Wulfran Bougouin
  • Lionel Lamhaut
  • Eloi Marijon
  • Daniel Jost
  • Florence Dumas
  • Nicolas Deye
  • Frankie Beganton
  • Jean-Philippe Empana
  • Emilie Chazelle
  • Alain Cariou
  • Xavier Jouven
Original

Abstract

Purpose

Sudden cardiac death (SCD) is a major public health concern, but data regarding epidemiology of this disease in Western European countries are outdated. This study reports the first results from a large registry of SCD.

Methods

A population-based registry was established in May 2011 using multiple sources to collect every case of SCD in Paris and its suburbs, covering a population of 6.6 million. Utstein variables were recorded. Pre-hospital and in-hospital data were considered, and the main outcome was survival at hospital discharge. Neurologic status at discharge was established as well.

Results

Of the 6,165 cases of SCD recorded over 2 years, 3,816 had a resuscitation attempt and represent the study population. Most patients were male (69 %), the SCD occurred at home (72 %) with bystanders in 80 % of cases, and cardiopulmonary resuscitation (CPR) was performed in 45 % of cases. Initial rhythm was shockable in 26 % of cases. A total of 1,332 patients (35 %) were admitted alive to hospital. Among hospitalized patients, 58 % had a coronary angiogram, and the same proportion had therapeutic hypothermia. Finally, 279 patients (7.5 %) were discharged alive, of whom 96 % had a favorable neurological outcome. In multivariate analysis, bystander CPR (OR 2.1, 95 % CI 1.5–3.1) and initial shockable rhythm (OR 11.5, 95 % CI 7.6–17.3) were positively associated with survival at hospital discharge, whereas age (OR 0.97 per year, 95 % CI 0.96–0.98), longer response time (OR 0.93 per minute, 95 % CI 0.89–0.97), occurrence at home (OR 0.4, 95 % CI 0.3–0.6), and epinephrine dose greater than 3 mg (OR 0.05, 95 % CI 0.03–0.08) were inversely associated with survival.

Conclusion

Despite being conducted in the therapeutic hypothermia and early coronary angiogram era, hospital discharge survival rate of resuscitated SCD remains poor. The current registry suggests ways to improve pre-hospital and in-hospital care of these patients.

Keywords

Sudden cardiac death Cardiac arrest Epidemiology Registry Prognosis 

Notes

Conflicts of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

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Supplementary material 1 (DOC 30 kb)
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Supplementary material 2 (DOC 33 kb)
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Supplementary material 3 (DOC 32 kb)
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Supplementary material 5 (DOCX 46 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2014

Authors and Affiliations

  • Wulfran Bougouin
    • 1
    • 2
    • 3
    • 4
  • Lionel Lamhaut
    • 1
    • 2
    • 4
    • 5
  • Eloi Marijon
    • 1
    • 2
    • 4
    • 6
  • Daniel Jost
    • 1
    • 4
    • 7
  • Florence Dumas
    • 1
    • 2
    • 4
    • 8
  • Nicolas Deye
    • 9
  • Frankie Beganton
    • 1
    • 2
    • 4
  • Jean-Philippe Empana
    • 1
    • 2
    • 4
  • Emilie Chazelle
    • 1
    • 2
    • 4
    • 6
  • Alain Cariou
    • 1
    • 2
    • 3
    • 4
  • Xavier Jouven
    • 1
    • 2
    • 4
    • 6
  1. 1.Paris Cardiovascular Research Center (PARCC), INSERM Unit 970ParisFrance
  2. 2.Université Paris Descartes-Sorbonne Paris CitéParisFrance
  3. 3.Medical Intensive Care UnitAP-HP, Cochin HospitalParis Cedex 14France
  4. 4.Paris Sudden Death Expertise CenterParisFrance
  5. 5.Intensive Care Unit and SAMU 75Necker Enfants-Malades Hospital, AP-HPParisFrance
  6. 6.Cardiology DepartmentGeorges Pompidou European Hospital, AP-HPParisFrance
  7. 7.Brigade de Sapeurs Pompiers de Paris (BSPP)ParisFrance
  8. 8.Emergency DepartmentCochin-Hotel-Dieu Hospital, APHPParisFrance
  9. 9.Medical Intensive Care UnitAP-HP, Lariboisière University Hospital, Inserm U942ParisFrance

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