Clinical predictors of shockable versus non-shockable rhythms in patients with out-of-hospital cardiac arrest

Asger Granfeldt; Mads Wissenberg; Steen Møller Hansen; Freddy K. Lippert; Torsten Lang-Jensen; Ole Mazur Hendriksen; Christian Torp-Pedersen; Erika Frischknecht Christensen; Christian Fynbo Christiansen

doi:10.1016/j.resuscitation.2016.08.024

Clinical predictors of shockable versus non-shockable rhythms in patients with out-of-hospital cardiac arrest

Asger Granfeldt^*, Mads Wissenberg, Steen Møller Hansen, Freddy K. Lippert, Torsten Lang-Jensen, Ole Mazur Hendriksen, Christian Torp-Pedersen, Erika Frischknecht Christensen, Christian Fynbo Christiansen

^*Corresponding author af dette arbejde

Institut for Klinisk Medicin

22 Citationer (Scopus)

Abstract

Aim To identify factors associated with a non-shockable rhythm as first recorded heart rhythm. Methods Patients ≥18 years old suffering out-of-hospital cardiac arrest between 2001 and 2012 were identified in the population-based Danish Cardiac Arrest Registry. Danish administrative registries were used to identify chronic diseases (within 10 years) and drug prescriptions (within 180 days). A multivariable logistic regression model, including patient related and cardiac arrest related characteristics, was used to estimate odds ratios (OR) for factors associated with non-shockable rhythm. Results A total of 29,863 patients were included: 6600 (22.1%) patients with a shockable rhythm and 23,263 (77.9%) patients with a non-shockable rhythm. A non-shockable rhythm was associated with female gender, arrest in private home, unwitnessed arrest, no bystander CPR, and longer time to first rhythm analysis compared to patients with shockable rhythm. In the adjusted multivariable regression model, pre-existing non-cardiovascular disease and drug prescription were associated with a non-shockable rhythm e.g. chronic obstructive lung disease (OR 1.44 [95% CI: 1.32–1.58]); and the prescription for antidepressants (OR 1.49 [95% CI: 1.35–1.65]), antipsychotics (OR 2.30 [95% CI: 1.96–2.69]) analgesics (OR 1.32 [95% CI: 1.23–1.41]), corticosteroids (OR 1.64 [95% CI: 1.44–1.85]), and antibiotics (OR 1.59 [95% CI: 1.40–1.81]). In contrast, the prescription of cardiovascular drugs and a history of cardiovascular disease e.g. ischemic heart disease was associated with a lower risk of non-shockable rhythm (OR 0.66 [95% CI: 0.60–0.71]). Conclusion This study demonstrate that non-cardiovascular disease and medication prescription are associated with a non-shockable rhythm while cardiovascular disease and medication prescription are associated with a shockable rhythm as first recorded rhythm in patients with OHCA.

Originalsprog	Engelsk
Tidsskrift	Resuscitation
Vol/bind	108
Sider (fra-til)	40-47
Antal sider	8
ISSN	0300-9572
DOI	https://doi.org/10.1016/j.resuscitation.2016.08.024
Status	Udgivet - 2016

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10.1016/j.resuscitation.2016.08.024

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@article{246f43c883ec457e8ccc4588400139c9,

title = "Clinical predictors of shockable versus non-shockable rhythms in patients with out-of-hospital cardiac arrest",

abstract = "Aim To identify factors associated with a non-shockable rhythm as first recorded heart rhythm. Methods Patients ≥18 years old suffering out-of-hospital cardiac arrest between 2001 and 2012 were identified in the population-based Danish Cardiac Arrest Registry. Danish administrative registries were used to identify chronic diseases (within 10 years) and drug prescriptions (within 180 days). A multivariable logistic regression model, including patient related and cardiac arrest related characteristics, was used to estimate odds ratios (OR) for factors associated with non-shockable rhythm. Results A total of 29,863 patients were included: 6600 (22.1%) patients with a shockable rhythm and 23,263 (77.9%) patients with a non-shockable rhythm. A non-shockable rhythm was associated with female gender, arrest in private home, unwitnessed arrest, no bystander CPR, and longer time to first rhythm analysis compared to patients with shockable rhythm. In the adjusted multivariable regression model, pre-existing non-cardiovascular disease and drug prescription were associated with a non-shockable rhythm e.g. chronic obstructive lung disease (OR 1.44 [95% CI: 1.32–1.58]); and the prescription for antidepressants (OR 1.49 [95% CI: 1.35–1.65]), antipsychotics (OR 2.30 [95% CI: 1.96–2.69]) analgesics (OR 1.32 [95% CI: 1.23–1.41]), corticosteroids (OR 1.64 [95% CI: 1.44–1.85]), and antibiotics (OR 1.59 [95% CI: 1.40–1.81]). In contrast, the prescription of cardiovascular drugs and a history of cardiovascular disease e.g. ischemic heart disease was associated with a lower risk of non-shockable rhythm (OR 0.66 [95% CI: 0.60–0.71]). Conclusion This study demonstrate that non-cardiovascular disease and medication prescription are associated with a non-shockable rhythm while cardiovascular disease and medication prescription are associated with a shockable rhythm as first recorded rhythm in patients with OHCA.",

keywords = "Arrhythmias, Cardiac comorbidities, Cardiopulmonary resuscitation, Cardiopulmonary resuscitation/epidemiology, Cardiopulmonary resuscitation/pharmacology, Out-of-hospital cardiac arrest",

author = "Asger Granfeldt and Mads Wissenberg and Hansen, {Steen M{\o}ller} and Lippert, {Freddy K.} and Torsten Lang-Jensen and Hendriksen, {Ole Mazur} and Christian Torp-Pedersen and Christensen, {Erika Frischknecht} and Christiansen, {Christian Fynbo}",

year = "2016",

doi = "10.1016/j.resuscitation.2016.08.024",

language = "English",

volume = "108",

pages = "40--47",

journal = "Resuscitation",

issn = "0300-9572",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Clinical predictors of shockable versus non-shockable rhythms in patients with out-of-hospital cardiac arrest

AU - Granfeldt, Asger

AU - Wissenberg, Mads

AU - Hansen, Steen Møller

AU - Lippert, Freddy K.

AU - Lang-Jensen, Torsten

AU - Hendriksen, Ole Mazur

AU - Torp-Pedersen, Christian

AU - Christensen, Erika Frischknecht

AU - Christiansen, Christian Fynbo

PY - 2016

Y1 - 2016

N2 - Aim To identify factors associated with a non-shockable rhythm as first recorded heart rhythm. Methods Patients ≥18 years old suffering out-of-hospital cardiac arrest between 2001 and 2012 were identified in the population-based Danish Cardiac Arrest Registry. Danish administrative registries were used to identify chronic diseases (within 10 years) and drug prescriptions (within 180 days). A multivariable logistic regression model, including patient related and cardiac arrest related characteristics, was used to estimate odds ratios (OR) for factors associated with non-shockable rhythm. Results A total of 29,863 patients were included: 6600 (22.1%) patients with a shockable rhythm and 23,263 (77.9%) patients with a non-shockable rhythm. A non-shockable rhythm was associated with female gender, arrest in private home, unwitnessed arrest, no bystander CPR, and longer time to first rhythm analysis compared to patients with shockable rhythm. In the adjusted multivariable regression model, pre-existing non-cardiovascular disease and drug prescription were associated with a non-shockable rhythm e.g. chronic obstructive lung disease (OR 1.44 [95% CI: 1.32–1.58]); and the prescription for antidepressants (OR 1.49 [95% CI: 1.35–1.65]), antipsychotics (OR 2.30 [95% CI: 1.96–2.69]) analgesics (OR 1.32 [95% CI: 1.23–1.41]), corticosteroids (OR 1.64 [95% CI: 1.44–1.85]), and antibiotics (OR 1.59 [95% CI: 1.40–1.81]). In contrast, the prescription of cardiovascular drugs and a history of cardiovascular disease e.g. ischemic heart disease was associated with a lower risk of non-shockable rhythm (OR 0.66 [95% CI: 0.60–0.71]). Conclusion This study demonstrate that non-cardiovascular disease and medication prescription are associated with a non-shockable rhythm while cardiovascular disease and medication prescription are associated with a shockable rhythm as first recorded rhythm in patients with OHCA.

AB - Aim To identify factors associated with a non-shockable rhythm as first recorded heart rhythm. Methods Patients ≥18 years old suffering out-of-hospital cardiac arrest between 2001 and 2012 were identified in the population-based Danish Cardiac Arrest Registry. Danish administrative registries were used to identify chronic diseases (within 10 years) and drug prescriptions (within 180 days). A multivariable logistic regression model, including patient related and cardiac arrest related characteristics, was used to estimate odds ratios (OR) for factors associated with non-shockable rhythm. Results A total of 29,863 patients were included: 6600 (22.1%) patients with a shockable rhythm and 23,263 (77.9%) patients with a non-shockable rhythm. A non-shockable rhythm was associated with female gender, arrest in private home, unwitnessed arrest, no bystander CPR, and longer time to first rhythm analysis compared to patients with shockable rhythm. In the adjusted multivariable regression model, pre-existing non-cardiovascular disease and drug prescription were associated with a non-shockable rhythm e.g. chronic obstructive lung disease (OR 1.44 [95% CI: 1.32–1.58]); and the prescription for antidepressants (OR 1.49 [95% CI: 1.35–1.65]), antipsychotics (OR 2.30 [95% CI: 1.96–2.69]) analgesics (OR 1.32 [95% CI: 1.23–1.41]), corticosteroids (OR 1.64 [95% CI: 1.44–1.85]), and antibiotics (OR 1.59 [95% CI: 1.40–1.81]). In contrast, the prescription of cardiovascular drugs and a history of cardiovascular disease e.g. ischemic heart disease was associated with a lower risk of non-shockable rhythm (OR 0.66 [95% CI: 0.60–0.71]). Conclusion This study demonstrate that non-cardiovascular disease and medication prescription are associated with a non-shockable rhythm while cardiovascular disease and medication prescription are associated with a shockable rhythm as first recorded rhythm in patients with OHCA.

KW - Arrhythmias

KW - Cardiac comorbidities

KW - Cardiopulmonary resuscitation

KW - Cardiopulmonary resuscitation/epidemiology

KW - Cardiopulmonary resuscitation/pharmacology

KW - Out-of-hospital cardiac arrest

U2 - 10.1016/j.resuscitation.2016.08.024

DO - 10.1016/j.resuscitation.2016.08.024

M3 - Journal article

C2 - 27616581

AN - SCOPUS:84987918329

SN - 0300-9572

VL - 108

SP - 40

EP - 47

JO - Resuscitation

JF - Resuscitation

ER -

Clinical predictors of shockable versus non-shockable rhythms in patients with out-of-hospital cardiac arrest

Abstract

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