Abstract 11589: Comorbidity and Medication Use Are Risk Factors of Non-shockable Rhythm in Patients With Out-of-hospital Cardiac Arrest
Introduction: Non-shockable rhythm (NSR) is the most prevalent heart rhythm for both in- and out-of-hospital cardiac arrest (OHCA). While survival from OHCA patients with a shockable rhythm (SR) has increased over time, survival following NSR remains low. Thus, identification of risk factors for NSR is important to reduce mortality.
We hypothesize that patients with NSR and SR are two disparate groups where patients with NSR are characterized by a high non-cardiac disease burden when compared to patients with SR.
Methods: Using data from the nationwide Danish Cardiac Arrest Registry (2001–2012), we identified 33,617 OHCA patients ≥18 years old. The Danish National Registry of Patients was used to identify comorbidities while the National Prescription Registry was used to identify drug prescriptions (within 180 days). A multivariable logistic regression model was used to estimate odds ratios for risk factors associated with NSR.
Results: Patients with NSR were characterized by a higher median age 71 years (IQR 60-81) vs. 67 years (IQR 58-77), higher proportion of women (38% vs. 21%), lower proportion of witnessed collapse (50% vs. 79%) and bystander CPR (27% vs. 50%) than patients with SR. A higher proportion of NSR occurred in private homes (77% vs. 58%) and time from recognition of OHCA to first rhythm analysis was longer: 13 min (IQR 7-22) vs. 9 min (IQR 6-14). In a fully adjusted model (patient-related and cardiac arrest-related characteristics included) a higher degree of comorbidity, psychiatric disease, chronic obstructive lung disease and the use of antidepressants, antipsychotics, anxiolytics, analgesics, corticosteroids, and antibiotics (within 14 days) where associated with NSR (Table). In contrast, the use of cardiovascular specific drugs and history of cardiovascular disease was associated with a lower risk of NSR.
Conclusion: A history of non-cardiac disease and non-cardiac drug use are risk factors of NSR when compared to patients with SR.
Author Disclosures: A. Granfeldt: None. M. Wissenberg: None. S.M. Hansen: None. C. Torp-Pedersen: None. E.F. Christensen: None. C.F. Christiansen: None.
- © 2015 by American Heart Association, Inc.