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Korean J Crit Care Med > Volume 26(3); 2011 > Article
Korean Journal of Critical Care Medicine 2011;26(3): 151-156. doi: https://doi.org/10.4266/kjccm.2011.26.3.151
비외상성 지주막하 출혈에 의한 병원 전 심정지 환자의 특성에 대한 연구
심민섭ㆍ성기동ㆍ강문주ㆍ나지웅ㆍ신태건ㆍ조익준ㆍ송형곤ㆍ송근정ㆍ정연권
성균관대학교 의과대학 삼성서울병원 응급의학과
A Retrospective Study about Characteristics of Out-of-hospital Cardiac Arrest Caused by Non-traumatic Subarachnoid Hemorrhage
Min Seob Sim, Ki Dong Sung, Mun Ju Kang, Ji Ung Na, Tae Gun Shin, Ik Joon Jo, Hyoung Gon Song, Keun Jeong Song, Yeon Kwon Jeong
Department of Emergency Medicine, Samsung Medical Center, Sunkyunkwan University School of Medicine, Seoul, Korea. coldco2@naver.com
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.
Key Words: subarachnoid hemorrhage; out-of-hospital cardiac arrest
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