Abstract 13512: Survival From Sudden Cardiac Arrest in the Hemodialysis Setting
Introduction: Sudden cardiac arrest (SCA) is the most common mode of death in dialysis patients, but there is little information regarding outcomes of resuscitation in this group of patients.
Hypothesis: There is a difference in resuscitation outcome from SCA in hemodialysis patients compared to those without renal disease.
Methods: Cases of out-of-hospital SCA, age ≥18 years were identified from an ongoing prospective community-based study in the Northwest US. Resuscitation variables were recorded from first responder reports. Renal disease and dialysis information was collected from patient’s medical history. Pearson’s chi-square tests and independent samples t-tests were used for univariate comparisons.
Results: Among 2311 cases identified (2002-2012) (mean age 64.5±16.9 years, 66.6% male), 90 cases were on chronic dialysis and 276 had chronic renal disease without dialysis. Resuscitation variables and outcomes were compared between patients on dialysis (dialysis group, n=90) and patients without chronic renal disease or dialysis (no renal disease group, n=1945). The two groups had similar mean age and sex distribution (p≥0.52). Dialysis cases were more likely to be black (26.7% vs. 5.9%) and less likely to be white (55.6% vs. 87.8%) (p<0.0001). There were significant differences in location of cardiac arrest (p<0.0001): dialysis cases were less likely to arrest in public locations (3.3% vs. 17.5%) and 16.7% arrested in a dialysis clinic. Dialysis cases were more likely to be witnessed (65.9% vs. 52.8%, p=0.02) but there was no difference in the proportion of bystander CPR (p=0.75). Response time was similar between the two groups (p=0.67). Resuscitation was attempted in 87.8% of dialysis patients versus 74.3% in no renal disease group (p=0.004). Although return of spontaneous circulation was achieved in 50.0% of dialysis group and 33.4% in the no renal disease group (p=0.003), survival to hospital discharge was similar between the two groups (11.4% vs. 11.8%, p=0.91).
Conclusions: Contrary to expectations, survival outcome from sudden cardiac arrest in hemodialysis patients is no different from those without renal disease.
Author Disclosures: C. Teodorescu: None. K. Reinier: None. A. Uy-Evanado: None. S. Mariani: None. R. Mariani: None. H. Chugh: None. K. Gunson: None. J. Jui: None. S.S. Chugh: Research Grant; Significant; NIH.
- © 2014 by American Heart Association, Inc.