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Effect of known history of heart disease on survival outcomes after out‐of‐hospital cardiac arrests
Author(s) -
Lee Magdalene HM,
FookChong Stephanie,
Wah Win,
Shin Sang Do,
Nishiuchi Tatsuya,
Ko Patrick ChowIn,
Naroo Ghulam Yasin,
Wong Kwanhathai Darin,
Tiah Ling,
Monsomboon Apichaya,
Siddiqui Fahad J,
Ong Marcus EH
Publication year - 2018
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12809
Subject(s) - medicine , odds ratio , heart disease , confidence interval , cardiopulmonary resuscitation , coronary artery disease , cardiology , disease , retrospective cohort study , resuscitation , surgery
Objective We aimed to investigate the effect of known heart disease on post‐out‐of‐hospital cardiac arrest ( OHCA ) survival outcomes, and its association with factors influencing survival. Methods This was an observational, retrospective study involving an OHCA database from seven Asian countries in 2009–2012. Heart disease was defined as a documented diagnosis of coronary artery disease or congenital heart disease. Patients with non‐traumatic arrests for whom resuscitation was attempted and with known medical histories were included. Differences in demographics, arrest characteristics and survival between patients with and without known heart disease were analysed. Multivariate logistic regression was performed to identify factors influencing survival to discharge. Results Of 19 044 eligible patients, 5687 had known heart disease. They were older (77 vs 72 years) and had more comorbidities like diabetes (40.9 vs 21.8%), hypertension (60.6 vs 36.0%) and previous stroke (15.2 vs 10.1%). However, they were not more likely to receive bystander cardiopulmonary resuscitation ( P = 0.205) or automated external defibrillation ( P = 0.980). On univariate analysis, known heart disease was associated with increased survival (unadjusted odds ratio 1.16, 95% confidence interval 1.03–1.30). However, on multivariate analysis, heart disease predicted poorer survival (adjusted odds ratio 0.76, 95% confidence interval 0.58–1.00). Other factors influencing survival corresponded with previous reports. Conclusions 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.