Effect of known history of heart disease on survival outcomes after out‐of‐hospital cardiac arrests

Lee, Magdalene Hui Min; Fook‐Chong, Stephanie; Wah, Win; Shin, Sang Do; Nishiuchi, Tatsuya; Ko, Patrick Chow-In; Naroo, Ghulam Yasin; Wong, Kwanhathai Darin; Tiah, Ling; Monsomboon, Apichaya; Siddiqui, Fahad Javaid; Ong, Marcus Eh

doi:10.1111/1742-6723.12809

Cited by 12 publications

(27 citation statements)

References 28 publications

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“…Results from each of the individual studies are shown online supplementary table 1 (for survival to hospital discharge outcomes) and online supplementary table 2 (for neurological outcomes). There were 18 studies conducted in Europe,3 5 10 13 15 28–40 four in the USA,8 12 41 42 three in Asia,20 26 43 two multinational studies,11 14 one in Australia9 and one in Canada 44. The number of patients enrolled in each study varied from n=6330 to n=2 47 684 41.…”

Section: Resultsmentioning

confidence: 99%

“…Patient inclusion age varied between studies, with 19 studies restricted to adults (≥16 years),3 8 9 12 20 26 28 29 31 33 36–44 one10 restricted to 70 years or over, seven placing no age restrictions5 11 13 15 32 34 35 and two studies being unclear about age 14 30. Cohort recruitment points varied greatly also, with 15 studies using scene of arrest as the enrolment point,5 8–11 13 20 31–33 38–40 42 44 6 using emergency department (ED) admission12 15 26 35–37 and 8 using hospital admission 3 14 28–30 34 41 43. Cardiac arrest aetiology was identified as either cardiac or non-traumatic in 12 studies,5 8–12 20 26 31 33 36 41 while the remaining studies either placed no restriction or were unclear.…”

Section: Resultsmentioning

confidence: 99%

“…Cohort recruitment points varied greatly also, with 15 studies using scene of arrest as the enrolment point,5 8–11 13 20 31–33 38–40 42 44 6 using emergency department (ED) admission12 15 26 35–37 and 8 using hospital admission 3 14 28–30 34 41 43. Cardiac arrest aetiology was identified as either cardiac or non-traumatic in 12 studies,5 8–12 20 26 31 33 36 41 while the remaining studies either placed no restriction or were unclear. Patient clinical inclusion characteristics were highly variable between the studies.…”

Section: Resultsmentioning

confidence: 99%

“…It has been suggested that a better understanding of the effect that comorbidity has on OHCA outcomes could lead to a number of benefits such as: improved understanding of the epidemiology of cardiac arrest,8 more informed end-of-life planning,9 10 improved public health policies to preemptively manage ‘at risk’ populations8 11 and improved prognostication 3 7 9 12. A number of authors have investigated the association between prearrest comorbidity and OHCA survival with some reporting comorbidity to be negatively associated with survival,6 13 while others reporting no relationship 14.…”

Section: Introductionmentioning

confidence: 99%

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Systematic review of the relationship between comorbidity and out-of-hospital cardiac arrest outcomes

2019

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ObjectivesTo assess the current evidence on the effect pre-arrest comorbidity has on survival and neurological outcomes following out-of-hospital cardiac arrest (OHCA).DesignSystematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Data sourcesMEDLINE, Ovid Embase, Scopus, CINAHL, Cochrane Library and MedNar were searched from inception to 31 December 2018.Eligibility criteriaStudies included if they examined the association between prearrest comorbidity and OHCA survival and neurological outcomes in adult or paediatric populations.Data extraction and synthesisData were extracted from individual studies but not pooled due to heterogeneity. Quality of included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale.ResultsThis review included 29 observational studies. There were high levels of clinical heterogeneity between studies with regards to patient recruitment, inclusion criteria, outcome measures and statistical methods used which ultimately resulted in a high risk of bias. Comorbidities reported across the studies were diverse, with some studies reporting individual comorbidities while others reported comorbidity burden using tools like the Charlson Comorbidity Index. Generally, prearrest comorbidity was associated with both reduced survival and poorer neurological outcomes following OHCA with 79% (74/94) of all reported adjusted results across 23 studies showing effect estimates suggesting lower survival with 42% (40/94) of these being statistically significant. OHCA survival was particularly reduced in patients with a prior history of diabetes (four out of six studies). However, a prearrest history of myocardial infarction appeared to be associated with increased survival in one of four studies.ConclusionsPrearrest comorbidity is generally associated with unfavourable OHCA outcomes, however differences between individual studies makes comparisons difficult. Due to the clinical and statistical heterogeneity across the studies, no meta-analysis was conducted. Future studies should follow a more standardised approach to investigating the impact of comorbidity on OHCA outcomes.PROSPERO registration numberCRD42018087578

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Systematic review of the relationship between comorbidity and out-of-hospital cardiac arrest outcomes

2019

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“…However, when this factor was associated with age and chronic health problems, the survival rate was low. 26 In the results of this study it was also found that the majority of the patients who survived cardiac arrest had a shockable rhythm, unlike those who did not (p <0,001 Another finding was with regard to the administration of defibrillation in the ambulance. It appeared that most of the patients survived the arrest, in contrast to the patients who did not receive defibrillation in the ambulance (p <0,001).…”

Section: Discussionmentioning

confidence: 52%

Survival rate of incoming patients with cardiac arrest at the cardiology infirmary of the emergency department of a public hospital in Greece

et al. 2019

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Introduction: Cardiac arrest is an urgent situation that, despite the improved resuscitation capabilities, the survival rate of out-of-hospital cardiac arrest victims remains low.Aim: Τo investigate the survival rate of the incoming patients with cardiac arrest in the cardiology infirmary of the emergency department of a public hospital.Material-Method: The study included 210 patients who were transferred pulseless and breathless at the cardiology infirmary of the emergency department of “Tzaneio” Hospital, Piraeus, during the period April 2017 - November 2018. Data was collected from the National Center of Emergency Dispatch's printed forms, as well as from the patients’ admission book of the emergency department.Results: More than 10% (11.9%) of patients with cardiac arrest returned to spontaneous circulation in the emergency department, of which 16% was discharged. Patients with known cardiac history, (p=0.002), with a shockable rhythm (p<0.001), and especially ventricular fibrillation (p<0.001) upon arrival at the emergency room, and patients who were defibrillated at the ambulance during admission and at the emergency room, were more likely to survive (p<0.001). No statistically significant correlation was found between the factors studied and survival after cardiac arrest, in the group of patients that were discharged.Conclusions: The survival rate of the incoming patients with cardiac arrest at the emergency department of “Tzaneio” Hospital, Piraeus, was low. As for most health systems, this issue constitutes a fairly complex public health problem. Cardiopulmonary resuscitation and corresponding guidelines require further improvement in order for the survival rates of out-of-hospital cardiac arrest patients to increase.

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Effect of hypertension across the age group on survival outcomes in out-of-hospital cardiac arrest

Jung

Park

et al. 2019

The American Journal of Emergency Medicine

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Effect of known history of heart disease on survival outcomes after out‐of‐hospital cardiac arrests

Abstract: 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.

Cited by 12 publications

References 28 publications

Systematic review of the relationship between comorbidity and out-of-hospital cardiac arrest outcomes

Systematic review of the relationship between comorbidity and out-of-hospital cardiac arrest outcomes

Survival rate of incoming patients with cardiac arrest at the cardiology infirmary of the emergency department of a public hospital in Greece

Effect of hypertension across the age group on survival outcomes in out-of-hospital cardiac arrest

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