Temporal trends in survival after out-of-hospital cardiac arrest in patients with and without underlying chronic obstructive pulmonary disease

• Published in: Resuscitation Vol. 104; pp. 76 - 82
• Main Authors: Møller, Sidsel G, Rajan, Shahzleen, Folke, Fredrik, Hansen, Carolina Malta, Hansen, Steen Møller, Kragholm, Kristian, Lippert, Freddy K, Karlsson, Lena, Køber, Lars, Torp-Pedersen, Christian, Gislason, Gunnar H, Wissenberg, Mads
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01-07-2016
• Subjects: Aged; Aged, 80 and over; Cardiopulmonary Resuscitation - statistics & numerical data; Case-Control Studies; Chi-Square Distribution; Chronic obstructive pulmonary disease; Comorbidity; CPR; Emergency; Emergency Medical Services - statistics & numerical data; Female; Heart rhythm; Humans; Improvements; Logistic Models; Male; Middle Aged; Out-of-hospital cardiac arrest; Out-of-Hospital Cardiac Arrest - mortality; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - mortality; Registries; Retrospective Studies; Survival; Survival Analysis; Time Factors; OHCA; Improvements; Out-of-hospital cardiac arrest; Heart rhythm; Chronic obstructive pulmonary disease; Survival, CPR; COPD; CPR; Survival
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2016.04.017

Abstract Aim Survival after out-of-hospital cardiac arrest (OHCA) has tripled during the past decade in Denmark as a likely result of improvements in cardiac arrest management. This study analyzed whether these improvements were applicable for patients with chronic obstructive pulmonary disease (COPD). Methods Patients ≥18 years with OHCA of presumed cardiac cause were identified through the Danish Cardiac Arrest Registry, 2001-2011. Patients with a history of COPD up to ten years prior to arrest were identified from the Danish National Patient Register and compared to non-COPD patients. Results Of 21,480 included patients, 3,056 (14.2%) had history of COPD. Compared to non-COPD patients, COPD patients were older (75 vs. 71 years), less likely male (61.2% vs. 68.5%), had higher prevalence of other comorbidities, and were less likely to have: arrests outside private homes (17.7% vs. 28.3%), witnessed arrests (48.7% vs. 52.9%), bystander cardiopulmonary resuscitation (25.8% vs. 34.8%), and shockable heart rhythm (15.6% vs. 29.9%), all p < 0.001; while no significant difference in the time-interval from recognition of arrest to rhythm analysis by ambulance-crew; p = 0.24. From 2001-2011; survival upon hospital arrival increased in both patient-groups (from 6.8% to 17.1% in COPD patients and from 8.2% to 25.6% in non-COPD patients, p < 0.001). However, no significant change was observed in 30-day survival in COPD patients (from 3.7% to 2.1%, p = 0.27), in contrast to non-COPD patients (from 3.5% to 13.0%, p < 0.001). Conclusions Despite generally improved 30-day survival after OHCA over time, no improvement was observed in 30-day survival in COPD patients.