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Introduction
We read with great interest the paper published by Hung et al describing the favorable impact of preceding statin therapy on survival following out-of-hospital cardiac arrest (OHCA). 1 Cardiac arrest remains a major cause of morbidity and mortality, despite improvement in resuscitation efforts. Statins have been shown to decrease the incidence of sudden cardiac death in ischemic heart disease. 2-4 We performed a retrospective study to examine the impact of statin pretreatment on in-hospital cardiac arrest (IHCA) survival.
Methods
This is a retrospective study conducted under the auspices of the Human Investigation Committee of the Research Institute of William Beaumont Hospital. All patients who suffered an IHCA and underwent cardiopulmonary resuscitation (CPR) at Beaumont hospital from April 2012 to December 2013 were included in the study. Exclusion criteria were for CPR in the setting of trauma, postoperatively, during pregnancy and postpartum. Out-of-the hospital cardiac arrest, patients who underwent hospice or palliative care approach were also excluded and patients with inadequate documentation were also excluded.
Survival was defined as survival to discharge. Patients were divided into two groups: survivors and non-survivors. CPR was performed by certified providers and the American Heart Association (AHA) guidelines for resuscitation were followed by all providers performing CPR.
Prearrest characteristics of the two groups were compared in a univariable analysis first, then we sought to find the strongest associations of survival. We completed a step-down logistic regression analysis. The least significant variable was dropped at each step until only those with a p value of <0.05 remained in the final model.
Results
During the study period, we found 479 patients who suffered cardiac arrest. We excluded the following groups: 85 patients who suffered out of the hospital cardiac arrest, postoperative CPR in 170 patients, CPR in the setting of trauma in 43 patients, 14 patients who underwent hospice/palliative care following CPR, postpartum CPR in two patients and 41 patients were excluded due to inadequate documentation. One hundred and twenty-four patients satisfied the inclusion and exclusion criteria. Of those, return of spontaneous circulation was achieved on 47 patients, three of whom died later on during...