Reduced in-hospital survival rates of out-of-hospital cardiac arrest victims with obstructive pulmonary disease |
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Authors: | MT Blom MJ Warnier A Bardai J Berdowski RW Koster PC Souverein AW Hoes FH Rutten A de Boer ML De Bruin HL Tan |
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Institution: | 1. Department of Cardiology, Academic Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands;2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands;3. Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, P.O. Box 80082, 3508 TB, Utrecht, The Netherlands;4. Interuniversity Cardiology Institute Netherlands, Utrecht, The Netherlands;5. Medicines Evaluation Board (CBG-MEB), P.O. Box 8275, 3503 RG, Utrecht, The Netherlands |
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Abstract: | AimOut-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.MethodsWe 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.ResultsOPD 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]).ConclusionOPD-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. |
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Keywords: | Out-of-hospital cardiac arrest Resuscitation Survival Obstructive pulmonary disease |
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