Trends in overdose-related out-of-hospital cardiac arrest in Arizona.

TitleTrends in overdose-related out-of-hospital cardiac arrest in Arizona.
Publication TypeJournal Article
Year of Publication2019
AuthorsSmith G, Beger S, Vadeboncoeur T, Chikani V, Walter F, Spaite DW, Bobrow B
Date Published2019 Jan
ISSN Number1873-1570

<p><b>AIM: </b>Opioid overdose mortality has increased in North America; however, recent regional trends in the proportion of treated overdose-related out-of-hospital cardiac arrest (OD-OHCA) compared to out-of-hospital cardiac arrest of presumed cardiac etiology (C-OHCA) are largely unknown. Our aim is to assess trends in the prevalence and outcomes of OD-OHCAs compared to C-OHCAs in Arizona.</p>

<p><b>METHODS: </b>Statewide, observational study utilizing an Utstein-style database with EMS-first care reports linked with hospital records, and vital statistics data from 2010 to 2015.</p>

<p><b>RESULTS: </b>There were 21,658 OHCAs during the study period. After excluding non-C-OHCAs, non-OD-OHCAs, and cases missing outcome data, 18,562 cases remained. Of these remaining cases, 17,591 (94.8%) were C-OHCAs and 971 (5.2%) were OD-OHCAs. There was a significant increase in the proportion of OD-OHCAs from 2010, 4.7% (95% CI: 3.9-5.5) to 2015, 6.6% (95% CI: 5.8-7.5). Mean age for OD-OHCAs was 38 years compared to 66 years for C-OHCAs, (p&thinsp;&lt;&thinsp;0.0001). Initial shockable rhythm was present in 7.1% of OD-OHCAs vs. 22.6% of C-OHCAs (p&thinsp;&lt;&thinsp;0.0001). Overall survival to discharge in the OD-OHCA group was 18.6% vs. 11.9% in C-OHCA (p&thinsp;&lt;&thinsp;0.0001). After risk adjustment, we found an aOR of 2.1 (95% CI: 1.8-2.6) for survival in OD-OHCA compared to C-OHCA.</p>

<p><b>CONCLUSION: </b>There has been a significant increase in the proportion of OD-OHCAs in Arizona between 2010-2015. OD-OHCA patients were younger, were less likely to present with a shockable rhythm, and more likely to survive than patients with C-OHCA. These data should be considered in prevention and treatment efforts.</p>

Alternate JournalResuscitation
PubMed ID30352247
Faculty Reference: 
Daniel W. Spaite, MD
Frank G. Walter, MD, FACEP, FACMT, FAACT