Effect of known history of heart disease on survival outcomes after out-of-hospital cardiac arrests
Journal
EMA - Emergency Medicine Australasia
Journal Volume
30
Journal Issue
1
Pages
67-76
Date Issued
2018
Author(s)
Lee M.H.M.
Fook-Chong S.
Wah W.
Shin S.D.
Nishiuchi T.
Naroo G.Y.
Wong K.D.
Tiah L.
Monsomboon A.
Siddiqui F.J.
Ong M.E.H.
on behalf of the PAROS Clinical Research Network
Abstract
Objective: We aimed to investigate the effect of known heart disease on post-out-of-hospital cardiac arrest (OHCA) survival outcomes, and its association with factors influencing survival. Methods: This was an observational, retrospective study involving an OHCA database from seven Asian countries in 2009–2012. Heart disease was defined as a documented diagnosis of coronary artery disease or congenital heart disease. Patients with non-traumatic arrests for whom resuscitation was attempted and with known medical histories were included. Differences in demographics, arrest characteristics and survival between patients with and without known heart disease were analysed. Multivariate logistic regression was performed to identify factors influencing survival to discharge. Results: Of 19 044 eligible patients, 5687 had known heart disease. They were older (77 vs 72 years) and had more comorbidities like diabetes (40.9 vs 21.8%), hypertension (60.6 vs 36.0%) and previous stroke (15.2 vs 10.1%). However, they were not more likely to receive bystander cardiopulmonary resuscitation (P = 0.205) or automated external defibrillation (P = 0.980). On univariate analysis, known heart disease was associated with increased survival (unadjusted odds ratio 1.16, 95% confidence interval 1.03–1.30). However, on multivariate analysis, heart disease predicted poorer survival (adjusted odds ratio 0.76, 95% confidence interval 0.58–1.00). Other factors influencing survival corresponded with previous reports. Conclusions: Known heart disease independently predicted poorer post-OHCA survival. This study may provide information to guide future prospective studies specifically looking at family education for patients with heart disease and the effect on OHCA outcomes. ? 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
SDGs
Other Subjects
adult; aged; Article; Asia; cerebrovascular accident; clinical feature; comorbidity; congenital heart disease; controlled study; coronary artery disease; diabetes mellitus; disease association; female; heart disease; hospital discharge; human; hypertension; major clinical study; male; medical history; observational study; out of hospital cardiac arrest; outcome assessment; priority journal; retrospective study; survival analysis; anamnesis; clinical trial; cohort analysis; complication; heart disease; middle aged; mortality; multicenter study; nonparametric test; out of hospital cardiac arrest; procedures; resuscitation; standards; statistical model; statistics and numerical data; survival analysis; very elderly; Aged; Aged, 80 and over; Asia; Cohort Studies; Comorbidity; Female; Heart Diseases; Humans; Logistic Models; Male; Medical History Taking; Middle Aged; Out-of-Hospital Cardiac Arrest; Resuscitation; Retrospective Studies; Statistics, Nonparametric; Survival Analysis
Type
journal article