Reduced in-hospital survival rates of out-of-hospital cardiac arrest victims with obstructive pulmonary disease

TY - JOUR

T1 - Reduced in-hospital survival rates of out-of-hospital cardiac arrest victims with obstructive pulmonary disease

AU - Blom, M T

AU - Warnier, M J

AU - Bardai, A

AU - Berdowski, J

AU - Koster, R W

AU - Souverein, P C

AU - Hoes, A W

AU - Rutten, F H

AU - de Boer, A

AU - De Bruin, M L

AU - Tan, H L

N1 - Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

PY - 2013/5

Y1 - 2013/5

N2 - AIM: Out-of-hospital cardiac arrest (OHCA) due to sustained ventricular tachycardia/fibrillation (VT/VF) is common and often lethal. Patient's co-morbidities may determine survival after OHCA, and be instrumental in post-resuscitation care, but are poorly studied. We aimed to study whether patients with obstructive pulmonary disease (OPD) have a lower survival rate after OHCA than non-OPD patients.METHODS: We performed a community-based cohort study of 1172 patients with non-traumatic OHCA with ECG-documented VT/VF between 2005 and 2008. We compared survival to emergency room (ER), to hospital admission, to hospital discharge, and at 30 days after OHCA, of OPD-patients and non-OPD patients, using logistic regression analysis. We also compared 30-day survival of patients who were admitted to hospital, using multivariate logistic regression analysis.RESULTS: OPD patients (n=178) and non-OPD patients (n=994) had comparable survival to ER (75% vs. 78%, OR 0.9 [95% CI: 0.6-1.3]) and to hospital admission (56% vs. 57%, OR 1.0 [0.7-1.4]). However, survival to hospital discharge was significantly lower among OPD patients (21% vs. 33%, OR 0.6 [0.4-0.9]). Multivariate regression analysis among patients who were admitted to hospital (OPD: n=100, no OPD: n=561) revealed that OPD was an independent determinant of reduced 30-day survival rate (39% vs. 59%, adjusted OR 0.6 [0.4-1.0, p=0.035]).CONCLUSION: OPD-patients had lower survival rates after OHCA than non-OPD patients. Survival to ER and to hospital admission was not different between both groups. However, among OHCA victims who survived to hospital admission, OPD was an independent determinant of reduced 30-day survival rate.

AB - AIM: Out-of-hospital cardiac arrest (OHCA) due to sustained ventricular tachycardia/fibrillation (VT/VF) is common and often lethal. Patient's co-morbidities may determine survival after OHCA, and be instrumental in post-resuscitation care, but are poorly studied. We aimed to study whether patients with obstructive pulmonary disease (OPD) have a lower survival rate after OHCA than non-OPD patients.METHODS: We performed a community-based cohort study of 1172 patients with non-traumatic OHCA with ECG-documented VT/VF between 2005 and 2008. We compared survival to emergency room (ER), to hospital admission, to hospital discharge, and at 30 days after OHCA, of OPD-patients and non-OPD patients, using logistic regression analysis. We also compared 30-day survival of patients who were admitted to hospital, using multivariate logistic regression analysis.RESULTS: OPD patients (n=178) and non-OPD patients (n=994) had comparable survival to ER (75% vs. 78%, OR 0.9 [95% CI: 0.6-1.3]) and to hospital admission (56% vs. 57%, OR 1.0 [0.7-1.4]). However, survival to hospital discharge was significantly lower among OPD patients (21% vs. 33%, OR 0.6 [0.4-0.9]). Multivariate regression analysis among patients who were admitted to hospital (OPD: n=100, no OPD: n=561) revealed that OPD was an independent determinant of reduced 30-day survival rate (39% vs. 59%, adjusted OR 0.6 [0.4-1.0, p=0.035]).CONCLUSION: OPD-patients had lower survival rates after OHCA than non-OPD patients. Survival to ER and to hospital admission was not different between both groups. However, among OHCA victims who survived to hospital admission, OPD was an independent determinant of reduced 30-day survival rate.

KW - Aged

KW - Cardiopulmonary Resuscitation

KW - Cohort Studies

KW - Emergency Service, Hospital

KW - Female

KW - Hospitalization

KW - Hospitals

KW - Humans

KW - Logistic Models

KW - Lung Diseases, Obstructive

KW - Male

KW - Middle Aged

KW - Netherlands

KW - Out-of-Hospital Cardiac Arrest

KW - Patient Discharge

KW - Survival Rate

KW - Tachycardia, Ventricular

KW - Ventricular Fibrillation

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1016/j.resuscitation.2012.10.009

DO - 10.1016/j.resuscitation.2012.10.009

M3 - Journal article

C2 - 23085404

SN - 0300-9572

VL - 84

SP - 569

EP - 574

JO - Resuscitation

JF - Resuscitation

IS - 5

ER -