Non-Prescription Drug-Associated Out-of-Hospital Cardiac Arrest: Changes in Incidence over Time and the Odds of Receiving Resuscitation.

Cardiac arrest Cardiopulmonary resuscitation Drug toxicity Out-of-hospital cardiac arrest Substance use disorder

Journal

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

Informations de publication

Date de publication:
29 Dec 2023
Historique:
received: 20 11 2023
revised: 22 12 2023
accepted: 27 12 2023
medline: 2 1 2024
pubmed: 2 1 2024
entrez: 31 12 2023
Statut: aheadofprint

Résumé

Multiple jurisdictions reported a significant increase in out-of-hospital cardiac arrest (OHCA) incidence over the past decade, however the reasons for this remain unclear. We investigated how drug-associated OHCA (DA-OHCA) contributed to overall OHCA incidence, and whether the likelihood of treatment by emergency medical services (EMS) was associated with DA-OHCA classification. Using a large provincial cardiac arrest registry, we included consecutive, non-traumatic adult OHCA from 2016-2022. We classified as drug-associated if there were historical accounts of non-prescription drug use within the preceding 24 hours or evidence of paraphernalia at the scene. We examined year-by-year trends in OHCA and DA-OHCA incidence. We also investigated the association between DA-OHCA and odds of EMS treatment using an adjusted logistic regression model. Of 33,365 EMS-assessed cases, 1,985/18,591 (11%) of EMS-treated OHCA and 887/9,200 (9.6%) of EMS-untreated OHCA were DA-OHCA. Of EMS-treated DA-OHCA, the median age was 40 years (IQR 31-51), 1,059 (53%) had a known history of non-prescription drug use, and 570 (29%) were public-location. From 2016 to 2022, EMS-treated OHCA incidence increased from 60 to 79 per 100,000 person-years; EMS-treated DA-OHCA incidence increased from 3.7 to 9.1 per 100,000 person-years. The proportion of overall OHCA classified as DA-OHCA increased from 6.1% to 11.5%. DA-OHCA was associated with greater odds of EMS treatment (AOR 1.34; 95%CI 1.13-1.58). Although EMS-treated DA-OHCA incidence increased by nearly three-fold, it comprised a minority of the overall OHCA increase during the study period. DA-OHCA was associated with an increased likelihood of EMS treatment.

Sections du résumé

BACKGROUND BACKGROUND
Multiple jurisdictions reported a significant increase in out-of-hospital cardiac arrest (OHCA) incidence over the past decade, however the reasons for this remain unclear. We investigated how drug-associated OHCA (DA-OHCA) contributed to overall OHCA incidence, and whether the likelihood of treatment by emergency medical services (EMS) was associated with DA-OHCA classification.
METHODS METHODS
Using a large provincial cardiac arrest registry, we included consecutive, non-traumatic adult OHCA from 2016-2022. We classified as drug-associated if there were historical accounts of non-prescription drug use within the preceding 24 hours or evidence of paraphernalia at the scene. We examined year-by-year trends in OHCA and DA-OHCA incidence. We also investigated the association between DA-OHCA and odds of EMS treatment using an adjusted logistic regression model.
RESULTS RESULTS
Of 33,365 EMS-assessed cases, 1,985/18,591 (11%) of EMS-treated OHCA and 887/9,200 (9.6%) of EMS-untreated OHCA were DA-OHCA. Of EMS-treated DA-OHCA, the median age was 40 years (IQR 31-51), 1,059 (53%) had a known history of non-prescription drug use, and 570 (29%) were public-location. From 2016 to 2022, EMS-treated OHCA incidence increased from 60 to 79 per 100,000 person-years; EMS-treated DA-OHCA incidence increased from 3.7 to 9.1 per 100,000 person-years. The proportion of overall OHCA classified as DA-OHCA increased from 6.1% to 11.5%. DA-OHCA was associated with greater odds of EMS treatment (AOR 1.34; 95%CI 1.13-1.58).
CONCLUSION CONCLUSIONS
Although EMS-treated DA-OHCA incidence increased by nearly three-fold, it comprised a minority of the overall OHCA increase during the study period. DA-OHCA was associated with an increased likelihood of EMS treatment.

Identifiants

DOI: 10.1016/j.resuscitation.2023.110107 PMID: 38160902
pubmed: 38160902
pii: S0300-9572(23)00843-2
doi: 10.1016/j.resuscitation.2023.110107
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

110107

Informations de copyright

Copyright © 2023. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Valerie Mok (V)

British Columbia Resuscitation Research Collaborative, British Columbia, Canada; Faculty of Medicine, University of British Columbia, British Columbia, Canada.

Callahan Brebner (C)

British Columbia Resuscitation Research Collaborative, British Columbia, Canada; Faculty of Medicine, University of British Columbia, British Columbia, Canada.

Justin Yap (J)

British Columbia Resuscitation Research Collaborative, British Columbia, Canada.

Michael Asamoah-Boaheng (M)

British Columbia Resuscitation Research Collaborative, British Columbia, Canada; Faculty of Medicine, University of British Columbia, British Columbia, Canada; Department of Emergency Medicine, University of British Columbia, British Columbia, Canada; Centre for Advancing Health Outcomes, St. Paul's Hospital, Vancouver, British Columbia, Canada.

Jacob Hutton (J)

British Columbia Resuscitation Research Collaborative, British Columbia, Canada; Faculty of Medicine, University of British Columbia, British Columbia, Canada; British Columbia Emergency Health Services, British Columbia, Canada.

Morgan Haines (M)

British Columbia Resuscitation Research Collaborative, British Columbia, Canada; Faculty of Medicine, University of British Columbia, British Columbia, Canada; Department of Emergency Medicine, University of British Columbia, British Columbia, Canada.

Frank Scheuermeyer (F)

British Columbia Resuscitation Research Collaborative, British Columbia, Canada; Faculty of Medicine, University of British Columbia, British Columbia, Canada; Department of Emergency Medicine, University of British Columbia, British Columbia, Canada; Centre for Advancing Health Outcomes, St. Paul's Hospital, Vancouver, British Columbia, Canada.

Takahisa Kawano (T)

British Columbia Resuscitation Research Collaborative, British Columbia, Canada; Department of Emergency Medicine, University of Fukui Hospital, Fukui Prefecture, Japan.

Jim Christenson (J)

British Columbia Resuscitation Research Collaborative, British Columbia, Canada; Faculty of Medicine, University of British Columbia, British Columbia, Canada; Department of Emergency Medicine, University of British Columbia, British Columbia, Canada; Centre for Advancing Health Outcomes, St. Paul's Hospital, Vancouver, British Columbia, Canada.

Brian Grunau (B)

British Columbia Resuscitation Research Collaborative, British Columbia, Canada; Faculty of Medicine, University of British Columbia, British Columbia, Canada; Department of Emergency Medicine, University of British Columbia, British Columbia, Canada; Centre for Advancing Health Outcomes, St. Paul's Hospital, Vancouver, British Columbia, Canada; British Columbia Emergency Health Services, British Columbia, Canada. Electronic address: Brian.Grunau@ubc.ca.

Classifications MeSH