Out-of-hospital cardiac arrest in patients with psychiatric disorders — Characteristics and outcomes

Carlo Alberto Barcella; Grimur H. Mohr; Kristian Kragholm; Paul Blanche; Thomas A. Gerds; Mads Wissenberg; Steen M. Hansen; Kristian Bundgaard; Freddy K. Lippert; Fredrik Folke; Christian Torp-Pedersen; Lars V. Kessing; Gunnar H. Gislason; Kathrine B. Søndergaard

doi:10.1016/j.resuscitation.2019.07.008

Out-of-hospital cardiac arrest in patients with psychiatric disorders — Characteristics and outcomes

Carlo Alberto Barcella^*, Grimur H. Mohr, Kristian Kragholm, Paul Blanche, Thomas A. Gerds, Mads Wissenberg, Steen M. Hansen, Kristian Bundgaard, Freddy K. Lippert, Fredrik Folke, Christian Torp-Pedersen, Lars V. Kessing, Gunnar H. Gislason, Kathrine B. Søndergaard

^*Corresponding author for this work

4 Citations (Scopus)

Abstract

Aims: To investigate whether the recent improvements in pre-hospital cardiac arrest-management and survival following out-of-hospital cardiac arrest (OHCA) also apply to OHCA patients with psychiatric disorders. Methods: We identified all adult Danish patients with OHCA of presumed cardiac cause, 2001–2015. Psychiatric disorders were defined by hospital diagnoses up to 10 years before OHCA and analyzed as one group as well as divided into five subgroups (schizophrenia-spectrum disorders, bipolar disorder, depression, substance-induced mental disorders, other psychiatric disorders). Association between psychiatric disorders and pre-hospital OHCA-characteristics and 30-day survival were assessed by multiple logistic regression. Results: Of 27,523 OHCA-patients, 4772 (17.3%) had a psychiatric diagnosis. Patients with psychiatric disorders had lower odds of 30-day survival (0.37 95% confidence interval 0.32–0.43) compared with other OHCA-patients. Likewise, they had lower odds of witnessed status (0.75 CI 0.70–0.80), bystander cardiopulmonary resuscitation (CPR) (0.77 CI 0.72–0.83), shockable heart rhythm (0.37 95% CI, 0.33–0.40), and return of spontaneous circulation (ROSC) at hospital arrival (0.66 CI 0.59–0.72). Similar results were seen in all five psychiatric subgroups. The difference in 30-day survival between patients with and without psychiatric disorders increased in recent years: from 8.4% (CI 7.0–10.0%) in 2006 to 13.9% (CI 12.4–15.4%) in 2015 and from 7.0% (4.3–10.8%) in 2006 to 7.0% (CI 4.5–9.7%) in 2015, respectively. Conclusion: Patients with psychiatric disorders have lower survival following OHCA compared to non-psychiatric patients and the gap between the two groups has widened over time.

Original language	English
Journal	Resuscitation
Volume	143
Pages (from-to)	180-188
Number of pages	9
ISSN	0300-9572
DOIs	https://doi.org/10.1016/j.resuscitation.2019.07.008
Publication status	Published - 2019

Keywords

Out-of-hospital cardiac arrest
Pre-hospital arrest management
Psychiatric disorders
Survival

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10.1016/j.resuscitation.2019.07.008

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Barcella, C. A., Mohr, G. H., Kragholm, K., Blanche, P., Gerds, T. A., Wissenberg, M., Hansen, S. M., Bundgaard, K., Lippert, F. K., Folke, F., Torp-Pedersen, C., Kessing, L. V., Gislason, G. H., & Søndergaard, K. B. (2019). Out-of-hospital cardiac arrest in patients with psychiatric disorders — Characteristics and outcomes. Resuscitation, 143, 180-188. https://doi.org/10.1016/j.resuscitation.2019.07.008

Barcella, CA, Mohr, GH, Kragholm, K, Blanche, P , Gerds, TA, Wissenberg, M, Hansen, SM, Bundgaard, K, Lippert, FK , Folke, F, Torp-Pedersen, C, Kessing, LV , Gislason, GH & Søndergaard, KB 2019, 'Out-of-hospital cardiac arrest in patients with psychiatric disorders — Characteristics and outcomes', Resuscitation, vol. 143, pp. 180-188. https://doi.org/10.1016/j.resuscitation.2019.07.008

@article{2d0cae7f0a004adf91a038ab1a9b72d5,

title = "Out-of-hospital cardiac arrest in patients with psychiatric disorders — Characteristics and outcomes",

abstract = "Aims: To investigate whether the recent improvements in pre-hospital cardiac arrest-management and survival following out-of-hospital cardiac arrest (OHCA) also apply to OHCA patients with psychiatric disorders. Methods: We identified all adult Danish patients with OHCA of presumed cardiac cause, 2001–2015. Psychiatric disorders were defined by hospital diagnoses up to 10 years before OHCA and analyzed as one group as well as divided into five subgroups (schizophrenia-spectrum disorders, bipolar disorder, depression, substance-induced mental disorders, other psychiatric disorders). Association between psychiatric disorders and pre-hospital OHCA-characteristics and 30-day survival were assessed by multiple logistic regression. Results: Of 27,523 OHCA-patients, 4772 (17.3%) had a psychiatric diagnosis. Patients with psychiatric disorders had lower odds of 30-day survival (0.37 95% confidence interval 0.32–0.43) compared with other OHCA-patients. Likewise, they had lower odds of witnessed status (0.75 CI 0.70–0.80), bystander cardiopulmonary resuscitation (CPR) (0.77 CI 0.72–0.83), shockable heart rhythm (0.37 95% CI, 0.33–0.40), and return of spontaneous circulation (ROSC) at hospital arrival (0.66 CI 0.59–0.72). Similar results were seen in all five psychiatric subgroups. The difference in 30-day survival between patients with and without psychiatric disorders increased in recent years: from 8.4% (CI 7.0–10.0%) in 2006 to 13.9% (CI 12.4–15.4%) in 2015 and from 7.0% (4.3–10.8%) in 2006 to 7.0% (CI 4.5–9.7%) in 2015, respectively. Conclusion: Patients with psychiatric disorders have lower survival following OHCA compared to non-psychiatric patients and the gap between the two groups has widened over time.",

keywords = "Out-of-hospital cardiac arrest, Pre-hospital arrest management, Psychiatric disorders, Survival",

author = "Barcella, {Carlo Alberto} and Mohr, {Grimur H.} and Kristian Kragholm and Paul Blanche and Gerds, {Thomas A.} and Mads Wissenberg and Hansen, {Steen M.} and Kristian Bundgaard and Lippert, {Freddy K.} and Fredrik Folke and Christian Torp-Pedersen and Kessing, {Lars V.} and Gislason, {Gunnar H.} and S{\o}ndergaard, {Kathrine B.}",

year = "2019",

doi = "10.1016/j.resuscitation.2019.07.008",

language = "English",

volume = "143",

pages = "180--188",

journal = "Resuscitation",

issn = "0300-9572",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Out-of-hospital cardiac arrest in patients with psychiatric disorders — Characteristics and outcomes

AU - Barcella, Carlo Alberto

AU - Mohr, Grimur H.

AU - Kragholm, Kristian

AU - Blanche, Paul

AU - Gerds, Thomas A.

AU - Wissenberg, Mads

AU - Hansen, Steen M.

AU - Bundgaard, Kristian

AU - Lippert, Freddy K.

AU - Folke, Fredrik

AU - Torp-Pedersen, Christian

AU - Kessing, Lars V.

AU - Gislason, Gunnar H.

AU - Søndergaard, Kathrine B.

PY - 2019

Y1 - 2019

N2 - Aims: To investigate whether the recent improvements in pre-hospital cardiac arrest-management and survival following out-of-hospital cardiac arrest (OHCA) also apply to OHCA patients with psychiatric disorders. Methods: We identified all adult Danish patients with OHCA of presumed cardiac cause, 2001–2015. Psychiatric disorders were defined by hospital diagnoses up to 10 years before OHCA and analyzed as one group as well as divided into five subgroups (schizophrenia-spectrum disorders, bipolar disorder, depression, substance-induced mental disorders, other psychiatric disorders). Association between psychiatric disorders and pre-hospital OHCA-characteristics and 30-day survival were assessed by multiple logistic regression. Results: Of 27,523 OHCA-patients, 4772 (17.3%) had a psychiatric diagnosis. Patients with psychiatric disorders had lower odds of 30-day survival (0.37 95% confidence interval 0.32–0.43) compared with other OHCA-patients. Likewise, they had lower odds of witnessed status (0.75 CI 0.70–0.80), bystander cardiopulmonary resuscitation (CPR) (0.77 CI 0.72–0.83), shockable heart rhythm (0.37 95% CI, 0.33–0.40), and return of spontaneous circulation (ROSC) at hospital arrival (0.66 CI 0.59–0.72). Similar results were seen in all five psychiatric subgroups. The difference in 30-day survival between patients with and without psychiatric disorders increased in recent years: from 8.4% (CI 7.0–10.0%) in 2006 to 13.9% (CI 12.4–15.4%) in 2015 and from 7.0% (4.3–10.8%) in 2006 to 7.0% (CI 4.5–9.7%) in 2015, respectively. Conclusion: Patients with psychiatric disorders have lower survival following OHCA compared to non-psychiatric patients and the gap between the two groups has widened over time.

AB - Aims: To investigate whether the recent improvements in pre-hospital cardiac arrest-management and survival following out-of-hospital cardiac arrest (OHCA) also apply to OHCA patients with psychiatric disorders. Methods: We identified all adult Danish patients with OHCA of presumed cardiac cause, 2001–2015. Psychiatric disorders were defined by hospital diagnoses up to 10 years before OHCA and analyzed as one group as well as divided into five subgroups (schizophrenia-spectrum disorders, bipolar disorder, depression, substance-induced mental disorders, other psychiatric disorders). Association between psychiatric disorders and pre-hospital OHCA-characteristics and 30-day survival were assessed by multiple logistic regression. Results: Of 27,523 OHCA-patients, 4772 (17.3%) had a psychiatric diagnosis. Patients with psychiatric disorders had lower odds of 30-day survival (0.37 95% confidence interval 0.32–0.43) compared with other OHCA-patients. Likewise, they had lower odds of witnessed status (0.75 CI 0.70–0.80), bystander cardiopulmonary resuscitation (CPR) (0.77 CI 0.72–0.83), shockable heart rhythm (0.37 95% CI, 0.33–0.40), and return of spontaneous circulation (ROSC) at hospital arrival (0.66 CI 0.59–0.72). Similar results were seen in all five psychiatric subgroups. The difference in 30-day survival between patients with and without psychiatric disorders increased in recent years: from 8.4% (CI 7.0–10.0%) in 2006 to 13.9% (CI 12.4–15.4%) in 2015 and from 7.0% (4.3–10.8%) in 2006 to 7.0% (CI 4.5–9.7%) in 2015, respectively. Conclusion: Patients with psychiatric disorders have lower survival following OHCA compared to non-psychiatric patients and the gap between the two groups has widened over time.

KW - Out-of-hospital cardiac arrest

KW - Pre-hospital arrest management

KW - Psychiatric disorders

KW - Survival

U2 - 10.1016/j.resuscitation.2019.07.008

DO - 10.1016/j.resuscitation.2019.07.008

M3 - Journal article

C2 - 31325557

AN - SCOPUS:85072351476

SN - 0300-9572

VL - 143

SP - 180

EP - 188

JO - Resuscitation

JF - Resuscitation

ER -

Out-of-hospital cardiac arrest in patients with psychiatric disorders — Characteristics and outcomes

Abstract

Keywords

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