Survival after out-of-hospital cardiac arrest in nursing homes - A nationwide study

Marianne Pape, Shahzleen Rajan, Steen Møller Hansen, Rikke Nørmark Mortensen, Signe Riddersholm, Fredrik Folke, Lena Karlsson, Freddy Lippert, Lars Køber, Gunnar Gislason, Helle Søholm, Mads Wissenberg, Thomas A. Gerds, Christian Torp-Pedersen, Kristian Kragholm

15 Citations (Scopus)

Abstract

Background: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents. Methods: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival. Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately. Results: Of 26,999 OCHAs, 2516 (9.3%) occurred in nursing homes, and 24,483 (90.7%) in private homes. Nursing home residents were older (median 83 (Q1–Q3: 75–89) vs. 71 (Q1–Q3: 61–80) years), had more witnessed arrest (55.4% vs. 43.4%), received more bystander cardiopulmonary resuscitation (CPR) (49.7% vs. 35.3%), but less pre-hospital defibrillation (15.1% vs. 29.8%). Registered AEDs increased in the period 2007–2014 from 1 to 211 in nursing homes vs. 1 to 488 in private homes. Average 30-day survival in nursing homes was 1.7% [95%CI: 1.2–2.2%] vs. 4.9% [95%CI: 4.6–5.2%] in private homes (P < 0.001). If bystanders witnessed the arrest, performed CPR, and pre-hospital defibrillation was performed, 30-day survival was 7.7% [95%CI: 3.5–11.9%] vs. 24.2% [95%CI: 22.5–25.9%] in nursing vs. private home residents. Conclusions: Average 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival.

Original languageEnglish
JournalResuscitation
Volume125
Pages (from-to)90-98
Number of pages9
ISSN0300-9572
DOIs
Publication statusPublished - Apr 2018

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