Abstract 14717: Location of Cardiac Arrest and Impact on Survival
Introduction: Cardiac arrest in a private location is associated with a higher mortality when compared to public location. Past studies have adjusted for cardiac arrest factors e.g. witnessed arrest and bystander cardiopulmonary resuscitation. However, pre-arrests factors such as chronic disease and medication may also be important.
Aim: To investigate the association between the location of cardiac arrest and 30-day mortality and in this regard the importance of chronic disease and medication use.
Methods: We identified 27,813 out-of-hospital cardiac arrest patients ≥18 years old from the Danish Cardiac Arrest Registry (2001–2012). Using National Registries, we identified chronic disease and medication use (< 180 days before arrest). To adjust for group differences we used propensity score matching followed by Cox regression to compute 30-day hazard ratio for death. To investigate the importance of cardiac arrest factors and pre-arrests factors we performed stepwise adjusted Cox regression analysis.
Results: Patients with cardiac arrest in a private location were older 72 years (IQR 61-81) vs. 67 years (IQR 58-78) and characterized by a lower proportion of witnessed collapse (44% vs. 58%), bystander CPR (30% vs. 50%) and shockable rhythms (16% vs. 33%). Estimated time from recognition of arrest to first rhythm analysis was longer: 12 min (IQR 7-21) vs. 10 min (IQR 6-16). In the propensity score adjusted analysis, public location was associated with a lower 30-day hazard ratio 0.94 (95%CI 0.90-0.98) (Figure). The stepwise adjusted regression analysis revealed that cardiac arrest factors had the largest impact on hazard ratio while no change in hazard ratio was seen when further adjusting for chronic disease and medication use.
Conclusion: Cardiac arrest in a public location is associated with a lower mortality when compared to private location despite adjusting for chronic disease and medication. The lower mortality is primarily linked to cardiac arrest factors.
Author Disclosures: A. Granfeldt: None. M. Mads Wissenberg: None. S.M. Hansen: None. F. Lippert: None. C. Torp-Pedersen: None. E.F. Christensen: None. C.F. Christiansen: None.
- © 2016 by American Heart Association, Inc.