Exercise-related out-of-hospital cardiac arrest in Victoria, Australia.


Journal

Resuscitation
ISSN: 1873-1570
Titre abrégé: Resuscitation
Pays: Ireland
ID NLM: 0332173

Informations de publication

Date de publication:
06 2019
Historique:
received: 09 02 2019
revised: 18 03 2019
accepted: 31 03 2019
pubmed: 15 4 2019
medline: 4 8 2020
entrez: 15 4 2019
Statut: ppublish

Résumé

Characteristics and outcomes of exercise-related out-of-hospital cardiac arrests (OHCA) are not well described in Australia. This was a retrospective observational study of non-exercise-related aetiology and exercise-related OHCAs from the Victorian Ambulance Cardiac Arrest Registry between 2008 and 2016, including 12-month quality of life data from 2010 to 2016. Exercise-related OHCA was defined as taking place during or within 1 h of at least moderate intensity exercise. Descriptive statistics and adjusted logistic regression analyses were performed. During the study period there were 482 exercise-related and 33,358 non-exercise-related OHCAs. Jogging/running were the most frequent precipitating sports. The incidence rate of exercise-related OHCA was low (<1 per 100,000 person-years). Compared to non-exercise-related aetiology, exercise-related OHCAs were younger (mean 54 versus 70 years, p < 0.001) and more likely to present in an initial shockable rhythm (85% versus 18%, p < 0.001). Bystander CPR, and bystander or EMS defibrillation at any time, were more common among exercise-related arrests (93% versus 38%, p < 0.001 and 91% versus 24%, p < 0.001, respectively). A public access defibrillator was used in 24% of shockable exercise-related OHCAs compared with 4% of non-exercise-related OHCAs (p < 0.001). After adjustment for arrest characteristics, exercise-related OHCAs were more likely to survive to hospital discharge (50% versus 14%, p < 0.001; adjusted odds ratio [AOR] = 1.56, 95% confidence interval [CI] 1.25-1.96, p < 0.001) and survive to 12-months with good functional recovery (72% versus 62%, p = 0.012; AOR = 1.57, 95% CI 1.08-2.28, p = 0.018). Exercise-related OHCAs were associated with better short- and long-term prognoses compared to non-exercise-related OHCAs. The underlying factors associated with this survival benefit warrant further investigation.

Sections du résumé

BACKGROUND
Characteristics and outcomes of exercise-related out-of-hospital cardiac arrests (OHCA) are not well described in Australia.
METHODS
This was a retrospective observational study of non-exercise-related aetiology and exercise-related OHCAs from the Victorian Ambulance Cardiac Arrest Registry between 2008 and 2016, including 12-month quality of life data from 2010 to 2016. Exercise-related OHCA was defined as taking place during or within 1 h of at least moderate intensity exercise. Descriptive statistics and adjusted logistic regression analyses were performed.
RESULTS
During the study period there were 482 exercise-related and 33,358 non-exercise-related OHCAs. Jogging/running were the most frequent precipitating sports. The incidence rate of exercise-related OHCA was low (<1 per 100,000 person-years). Compared to non-exercise-related aetiology, exercise-related OHCAs were younger (mean 54 versus 70 years, p < 0.001) and more likely to present in an initial shockable rhythm (85% versus 18%, p < 0.001). Bystander CPR, and bystander or EMS defibrillation at any time, were more common among exercise-related arrests (93% versus 38%, p < 0.001 and 91% versus 24%, p < 0.001, respectively). A public access defibrillator was used in 24% of shockable exercise-related OHCAs compared with 4% of non-exercise-related OHCAs (p < 0.001). After adjustment for arrest characteristics, exercise-related OHCAs were more likely to survive to hospital discharge (50% versus 14%, p < 0.001; adjusted odds ratio [AOR] = 1.56, 95% confidence interval [CI] 1.25-1.96, p < 0.001) and survive to 12-months with good functional recovery (72% versus 62%, p = 0.012; AOR = 1.57, 95% CI 1.08-2.28, p = 0.018).
CONCLUSIONS
Exercise-related OHCAs were associated with better short- and long-term prognoses compared to non-exercise-related OHCAs. The underlying factors associated with this survival benefit warrant further investigation.

Identifiants

pubmed: 30981883
pii: S0300-9572(19)30112-1
doi: 10.1016/j.resuscitation.2019.03.043
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

57-64

Informations de copyright

Crown Copyright © 2019. Published by Elsevier B.V. All rights reserved.

Auteurs

David Eastwood (D)

Harrogate and District NHS Foundation Trust, North Yorkshire, UK. Electronic address: david.eastwood@doctors.org.uk.

Emily Andrew (E)

Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Karen Smith (K)

Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia.

Resmi Nair (R)

Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Victoria, Australia.

Ziad Nehme (Z)

Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia.

Stephen Bernard (S)

Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; The Alfred Hospital, Melbourne, Victoria, Australia.

Kylie Dyson (K)

Centre for Research and Evaluation, Ambulance Victoria, Doncaster, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

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