RT Journal Article
SR Electronic
T1 Higher chances of survival to hospital admission after out-of-hospital cardiac arrest in patients with previously diagnosed heart disease
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e001805
DO 10.1136/openhrt-2021-001805
VO 8
IS 2
A1 Laura H van Dongen
A1 Marieke T Blom
A1 Sandra C M de Haas
A1 Henk C P M van Weert
A1 Petra J M Elders
A1 Hanno L Tan
A1 ,
YR 2021
UL http://openheart.bmj.com/content/8/2/e001805.abstract
AB Aim This study aimed to determine whether patients suffering from out-of-hospital cardiac arrest (OHCA) with a pre-OHCA diagnosis of heart disease have higher survival chances than patients without such a diagnosis and to explore possible underlying mechanisms.Methods A retrospective cohort study in 3760 OHCA patients from the Netherlands (2010–2016) was performed. Information from emergency medical services, treating hospitals, general practitioner, resuscitation ECGs and civil registry was used to assess medical histories and the presence of pre-OHCA diagnosis of heart disease. We used multivariable regression analysis to calculate associations with survival to hospital admission or discharge, immediate causes of OHCA (acute myocardial infarction (AMI) vs non-AMI) and initial recorded rhythm.Results Overall, 48.1% of OHCA patients had pre-OHCA heart disease. These patients had higher odds to survive to hospital admission than patients without pre-OHCA heart disease (OR 1.25 (95%CI 1.05 to 1.47)), despite being older and more often having cardiovascular risk factors and some non-cardiac comorbidities. These patients also had higher odds of shockable initial rhythm (SIR) (OR 1.60 (1. 36 to 1.89)) and a lower odds of AMI as immediate cause of OHCA (OR 0.33 (0.25 to 0.42)). Their chances of survival to hospital discharge were not significantly larger (OR 1.16 (0.95 to 1.42)).Conclusion Having pre-OHCA diagnosed heart disease is associated with better odds to survive to hospital admission, but not to hospital discharge. This is associated with higher odds of a SIR and in a subgroup with available diagnosis a lower proportion of AMI as immediate cause of OHCA.The data underlying this article are available in the article and in its online supplementary material. The data cannot be shared publicly for privacy of individuals that participated in the study as data cannot be provided completely anonymous according to the Medical Ethics Committee and the Data Protection Officer of our institution.