Journal
RESUSCITATION
Volume 84, Issue 5, Pages 569-574Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.resuscitation.2012.10.009
Keywords
Out-of-hospital cardiac arrest; Resuscitation; Survival; Obstructive pulmonary disease
Categories
Funding
- Netherlands Organization for Scientific Research (NWO) [ZonMW Vici 918.86.616, Mozaiek 017.003.084]
- Dutch Medicines Evaluation Board (MEB/CBG)
- European Community's Seventh Framework Programme [241679]
- Netherlands Organisation for Health Research and Development (ZonMW)
- Dutch Health Care Insurance Board (CVZ)
- Royal Dutch Pharmacists Association (KNMP)
- EU Innovative Medicines Initiative (IMI)
- EU 7th Framework Program (FP7)
- Dutch Medicines Evaluation Board
- Dutch Ministry of Health and Industry
- GlaxoSmithKline
- Pfizer
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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. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
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