Temporal trends in survival after out-of-hospital cardiac arrest in patients with and without underlying chronic obstructive pulmonary disease.

Abstract

AIM:

Survival after out-of-hospital cardiac arrest (OHCA) has tripled during the past decade in Denmark as a likely result of improvements in cardiac arrest management. This study analyzed whether these improvements were applicable for patients with chronic obstructive pulmonary disease (COPD).

METHODS:

Patients ≥18 years with OHCA of presumed cardiac cause were identified through the Danish Cardiac Arrest Registry, 2001-2011. Patients with a history of COPD up to ten years prior to arrest were identified from the Danish National Patient Register and compared to non-COPD patients.

RESULTS:

Of 21,480 included patients, 3056 (14.2%) had history of COPD. Compared to non-COPD patients, COPD patients were older (75 vs. 71 years), less likely male (61.2% vs. 68.5%), had higher prevalence of other comorbidities, and were less likely to have: arrests outside private homes (17.7% vs. 28.3%), witnessed arrests (48.7% vs. 52.9%), bystander cardiopulmonary resuscitation (25.8% vs. 34.8%), and shockable heart rhythm (15.6% vs. 29.9%), all p<0.001; while no significant difference in the time-interval from recognition of arrest to rhythm analysis by ambulance-crew; p=0.24. From 2001 to 2011, survival upon hospital arrival increased in both patient-groups (from 6.8% to 17.1% in COPD patients and from 8.2% to 25.6% in non-COPD patients, p<0.001). However, no significant change was observed in 30-day survival in COPD patients (from 3.7% to 2.1%, p=0.27), in contrast to non-COPD patients (from 3.5% to 13.0%, p<0.001).

CONCLUSIONS:

Despite generally improved 30-day survival after OHCA over time, no improvement was observed in 30-day survival in COPD patients.

• Authors: Sidsel G Møller, Shahzleen Rajan, Fredrik Folke, Carolina Malta Hansen, Steen Møller Hansen, Kristian Kragholm, Freddy K Lippert, Lena Karlsson, Lars Køber, Christian Torp-Pedersen, Gunnar H Gislason, Mads Wissenberg
• Journal: Resuscitation (Resuscitation) Vol. 104 Pg. 76-82 (07 2016) ISSN: 1873-1570 [Electronic] Ireland
• PMID: 27164010 (Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Topics

• Aged
• Aged, 80 and over
• Cardiopulmonary Resuscitation (statistics & numerical data)
• Case-Control Studies
• Chi-Square Distribution
• Comorbidity
• Emergency Medical Services (statistics & numerical data)
• Female
• Humans
• Logistic Models
• Male
• Middle Aged
• Out-of-Hospital Cardiac Arrest (mortality)
• Pulmonary Disease, Chronic Obstructive (complications, mortality)
• Registries
• Retrospective Studies
• Survival Analysis
• Time Factors