Trends in overdose-related out-of-hospital cardiac arrest in Arizona

Gabriella Smith, Samuel Beger, Tyler Vadeboncoeur, Vatsal Chikani, Frank G Walter, Daniel W Spaite, Bentley J Bobrow

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Aim: Opioid overdose mortality has increased in North America; however, recent regional trends in the proportion of treated overdose-related out-of-hospital cardiac arrest (OD-OHCA) compared to out-of-hospital cardiac arrest of presumed cardiac etiology (C-OHCA) are largely unknown. Our aim is to assess trends in the prevalence and outcomes of OD-OHCAs compared to C-OHCAs in Arizona. Methods: Statewide, observational study utilizing an Utstein-style database with EMS-first care reports linked with hospital records, and vital statistics data from 2010 to 2015. Results: There were 21,658 OHCAs during the study period. After excluding non-C-OHCAs, non-OD-OHCAs, and cases missing outcome data, 18,562 cases remained. Of these remaining cases, 17,591 (94.8%) were C-OHCAs and 971 (5.2%) were OD-OHCAs. There was a significant increase in the proportion of OD-OHCAs from 2010, 4.7% (95% CI: 3.9–5.5) to 2015, 6.6% (95% CI: 5.8–7.5). Mean age for OD-OHCAs was 38 years compared to 66 years for C-OHCAs, (p < 0.0001). Initial shockable rhythm was present in 7.1% of OD-OHCAs vs. 22.6% of C-OHCAs (p < 0.0001). Overall survival to discharge in the OD-OHCA group was 18.6% vs. 11.9% in C-OHCA (p < 0.0001). After risk adjustment, we found an aOR of 2.1 (95% CI: 1.8-2.6) for survival in OD-OHCA compared to C-OHCA. Conclusion: There has been a significant increase in the proportion of OD-OHCAs in Arizona between 2010–2015. OD-OHCA patients were younger, were less likely to present with a shockable rhythm, and more likely to survive than patients with C-OHCA. These data should be considered in prevention and treatment efforts.

Original languageEnglish (US)
Pages (from-to)122-126
Number of pages5
JournalResuscitation
Volume134
DOIs
StatePublished - Jan 1 2019

Fingerprint

Out-of-Hospital Cardiac Arrest
Risk Adjustment
Vital Statistics
Survival
Hospital Records
North America
Opioid Analgesics
Observational Studies
Databases
Mortality

Keywords

  • ACLS
  • Arizona
  • BLS
  • Cardiac arrest
  • Compression-only CPR
  • CPR
  • Epidemiology
  • Naloxone
  • OD-OHCA
  • OHCA
  • Opioid
  • Out-of-hospital cardiac arrest
  • Overdose
  • Overdose-related
  • Resuscitation

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this

Trends in overdose-related out-of-hospital cardiac arrest in Arizona. / Smith, Gabriella; Beger, Samuel; Vadeboncoeur, Tyler; Chikani, Vatsal; Walter, Frank G; Spaite, Daniel W; Bobrow, Bentley J.

In: Resuscitation, Vol. 134, 01.01.2019, p. 122-126.

Research output: Contribution to journalArticle

Smith, Gabriella ; Beger, Samuel ; Vadeboncoeur, Tyler ; Chikani, Vatsal ; Walter, Frank G ; Spaite, Daniel W ; Bobrow, Bentley J. / Trends in overdose-related out-of-hospital cardiac arrest in Arizona. In: Resuscitation. 2019 ; Vol. 134. pp. 122-126.
@article{03475f7d23704d9296a93513df7f9c86,
title = "Trends in overdose-related out-of-hospital cardiac arrest in Arizona",
abstract = "Aim: Opioid overdose mortality has increased in North America; however, recent regional trends in the proportion of treated overdose-related out-of-hospital cardiac arrest (OD-OHCA) compared to out-of-hospital cardiac arrest of presumed cardiac etiology (C-OHCA) are largely unknown. Our aim is to assess trends in the prevalence and outcomes of OD-OHCAs compared to C-OHCAs in Arizona. Methods: Statewide, observational study utilizing an Utstein-style database with EMS-first care reports linked with hospital records, and vital statistics data from 2010 to 2015. Results: There were 21,658 OHCAs during the study period. After excluding non-C-OHCAs, non-OD-OHCAs, and cases missing outcome data, 18,562 cases remained. Of these remaining cases, 17,591 (94.8{\%}) were C-OHCAs and 971 (5.2{\%}) were OD-OHCAs. There was a significant increase in the proportion of OD-OHCAs from 2010, 4.7{\%} (95{\%} CI: 3.9–5.5) to 2015, 6.6{\%} (95{\%} CI: 5.8–7.5). Mean age for OD-OHCAs was 38 years compared to 66 years for C-OHCAs, (p < 0.0001). Initial shockable rhythm was present in 7.1{\%} of OD-OHCAs vs. 22.6{\%} of C-OHCAs (p < 0.0001). Overall survival to discharge in the OD-OHCA group was 18.6{\%} vs. 11.9{\%} in C-OHCA (p < 0.0001). After risk adjustment, we found an aOR of 2.1 (95{\%} CI: 1.8-2.6) for survival in OD-OHCA compared to C-OHCA. Conclusion: There has been a significant increase in the proportion of OD-OHCAs in Arizona between 2010–2015. OD-OHCA patients were younger, were less likely to present with a shockable rhythm, and more likely to survive than patients with C-OHCA. These data should be considered in prevention and treatment efforts.",
keywords = "ACLS, Arizona, BLS, Cardiac arrest, Compression-only CPR, CPR, Epidemiology, Naloxone, OD-OHCA, OHCA, Opioid, Out-of-hospital cardiac arrest, Overdose, Overdose-related, Resuscitation",
author = "Gabriella Smith and Samuel Beger and Tyler Vadeboncoeur and Vatsal Chikani and Walter, {Frank G} and Spaite, {Daniel W} and Bobrow, {Bentley J}",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.resuscitation.2018.10.019",
language = "English (US)",
volume = "134",
pages = "122--126",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Trends in overdose-related out-of-hospital cardiac arrest in Arizona

AU - Smith, Gabriella

AU - Beger, Samuel

AU - Vadeboncoeur, Tyler

AU - Chikani, Vatsal

AU - Walter, Frank G

AU - Spaite, Daniel W

AU - Bobrow, Bentley J

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Aim: Opioid overdose mortality has increased in North America; however, recent regional trends in the proportion of treated overdose-related out-of-hospital cardiac arrest (OD-OHCA) compared to out-of-hospital cardiac arrest of presumed cardiac etiology (C-OHCA) are largely unknown. Our aim is to assess trends in the prevalence and outcomes of OD-OHCAs compared to C-OHCAs in Arizona. Methods: Statewide, observational study utilizing an Utstein-style database with EMS-first care reports linked with hospital records, and vital statistics data from 2010 to 2015. Results: There were 21,658 OHCAs during the study period. After excluding non-C-OHCAs, non-OD-OHCAs, and cases missing outcome data, 18,562 cases remained. Of these remaining cases, 17,591 (94.8%) were C-OHCAs and 971 (5.2%) were OD-OHCAs. There was a significant increase in the proportion of OD-OHCAs from 2010, 4.7% (95% CI: 3.9–5.5) to 2015, 6.6% (95% CI: 5.8–7.5). Mean age for OD-OHCAs was 38 years compared to 66 years for C-OHCAs, (p < 0.0001). Initial shockable rhythm was present in 7.1% of OD-OHCAs vs. 22.6% of C-OHCAs (p < 0.0001). Overall survival to discharge in the OD-OHCA group was 18.6% vs. 11.9% in C-OHCA (p < 0.0001). After risk adjustment, we found an aOR of 2.1 (95% CI: 1.8-2.6) for survival in OD-OHCA compared to C-OHCA. Conclusion: There has been a significant increase in the proportion of OD-OHCAs in Arizona between 2010–2015. OD-OHCA patients were younger, were less likely to present with a shockable rhythm, and more likely to survive than patients with C-OHCA. These data should be considered in prevention and treatment efforts.

AB - Aim: Opioid overdose mortality has increased in North America; however, recent regional trends in the proportion of treated overdose-related out-of-hospital cardiac arrest (OD-OHCA) compared to out-of-hospital cardiac arrest of presumed cardiac etiology (C-OHCA) are largely unknown. Our aim is to assess trends in the prevalence and outcomes of OD-OHCAs compared to C-OHCAs in Arizona. Methods: Statewide, observational study utilizing an Utstein-style database with EMS-first care reports linked with hospital records, and vital statistics data from 2010 to 2015. Results: There were 21,658 OHCAs during the study period. After excluding non-C-OHCAs, non-OD-OHCAs, and cases missing outcome data, 18,562 cases remained. Of these remaining cases, 17,591 (94.8%) were C-OHCAs and 971 (5.2%) were OD-OHCAs. There was a significant increase in the proportion of OD-OHCAs from 2010, 4.7% (95% CI: 3.9–5.5) to 2015, 6.6% (95% CI: 5.8–7.5). Mean age for OD-OHCAs was 38 years compared to 66 years for C-OHCAs, (p < 0.0001). Initial shockable rhythm was present in 7.1% of OD-OHCAs vs. 22.6% of C-OHCAs (p < 0.0001). Overall survival to discharge in the OD-OHCA group was 18.6% vs. 11.9% in C-OHCA (p < 0.0001). After risk adjustment, we found an aOR of 2.1 (95% CI: 1.8-2.6) for survival in OD-OHCA compared to C-OHCA. Conclusion: There has been a significant increase in the proportion of OD-OHCAs in Arizona between 2010–2015. OD-OHCA patients were younger, were less likely to present with a shockable rhythm, and more likely to survive than patients with C-OHCA. These data should be considered in prevention and treatment efforts.

KW - ACLS

KW - Arizona

KW - BLS

KW - Cardiac arrest

KW - Compression-only CPR

KW - CPR

KW - Epidemiology

KW - Naloxone

KW - OD-OHCA

KW - OHCA

KW - Opioid

KW - Out-of-hospital cardiac arrest

KW - Overdose

KW - Overdose-related

KW - Resuscitation

UR - http://www.scopus.com/inward/record.url?scp=85060354202&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060354202&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2018.10.019

DO - 10.1016/j.resuscitation.2018.10.019

M3 - Article

VL - 134

SP - 122

EP - 126

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -