Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort studyResearch in context
Summary: Background: Understanding the long-term outcomes and disability-adjusted life years (DALY) after out-of-hospital cardiac arrest (OHCA) is important to understand the overall health and disease burden of OHCA respectively, but data in Asia remains limited. We aimed to quantify long-term sur...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-03-01
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| Series: | The Lancet Regional Health. Western Pacific |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666606522002875 |
| _version_ | 1828048245899657216 |
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| author | Andrew Fu Wah Ho Mervyn Jun Rui Lim Arul Earnest Audrey Blewer Nicholas Graves Jun Wei Yeo Pin Pin Pek Ling Tiah Marcus Eng Hock Ong Michael Y.C. Chia Yih Yng Ng Benjamin S.H. Leong Han Nee Gan Wei Ming Ng Si Oon Cheah Desmond R. Mao Nausheen Edwin Shalini Arulanandam |
| author_facet | Andrew Fu Wah Ho Mervyn Jun Rui Lim Arul Earnest Audrey Blewer Nicholas Graves Jun Wei Yeo Pin Pin Pek Ling Tiah Marcus Eng Hock Ong Michael Y.C. Chia Yih Yng Ng Benjamin S.H. Leong Han Nee Gan Wei Ming Ng Si Oon Cheah Desmond R. Mao Nausheen Edwin Shalini Arulanandam |
| author_sort | Andrew Fu Wah Ho |
| collection | DOAJ |
| description | Summary: Background: Understanding the long-term outcomes and disability-adjusted life years (DALY) after out-of-hospital cardiac arrest (OHCA) is important to understand the overall health and disease burden of OHCA respectively, but data in Asia remains limited. We aimed to quantify long-term survival and the annual disease burden of OHCA within a national multi-ethnic Asian cohort. Methods: We conducted an open cohort study linking the Singapore Pan-Asian Resuscitation Outcomes Study (PAROS) and the Singapore Registry of Births and Deaths from 2010 to 2019. We performed Cox regression, constructed Kaplan–Meier curves, and calculated DALYs and standardised mortality ratios (SMR) for each year of follow-up. Results: We analysed 802 cases. The mean age was 56.0 (SD 17.8). Most were male (631 cases, 78,7%) and of Chinese ethnicity (552 cases, 68.8%). At one year, the SMR was 14.9 (95% CI:12.5–17.8), decreasing to 1.2 (95% CI:0.7–1.8) at three years, and 0.4 (95% CI:0.2–0.8) at five years. Age at arrest (HR:1.03, 95% CI:1.02–1.04, p < 0.001), shockable presenting rhythm (HR:0.75, 95% CI:0.52–0.93, p = 0.015) and CPC category (HR:4.62, 95% CI:3.17–6.75, p < 0.001) were independently associated with mortality. Annual DALYs due to OHCA varied from 304.1 in 2010 to 849.7 in 2015, then 547.1 in 2018. Mean DALYs decreased from 12.162 in 2010 to 3.599 in 2018. Conclusions: OHCA survivors had an increased mortality rate for the first three years which subsequently normalised compared to that of the general population. Annual OHCA disease burden in DALY trended downwards from 2010 to 2018. Improved surveillance and OHCA treatment strategies may improve long-term survivorship and decrease its global burden. Funding: National Medical Research Council, Singapore, under the Clinician Scientist Award (NMRC/CSA-SI/0014/2017) and the Singapore Translational Research Investigator Award (MOH-000982-01). |
| first_indexed | 2024-04-10T18:53:29Z |
| format | Article |
| id | doaj.art-45285b797fb548819de921abce1c8da0 |
| institution | Directory Open Access Journal |
| issn | 2666-6065 |
| language | English |
| last_indexed | 2024-04-10T18:53:29Z |
| publishDate | 2023-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Western Pacific |
| spelling | doaj.art-45285b797fb548819de921abce1c8da02023-02-01T04:28:03ZengElsevierThe Lancet Regional Health. Western Pacific2666-60652023-03-0132100672Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort studyResearch in contextAndrew Fu Wah Ho0Mervyn Jun Rui Lim1Arul Earnest2Audrey Blewer3Nicholas Graves4Jun Wei Yeo5Pin Pin Pek6Ling Tiah7Marcus Eng Hock Ong8Michael Y.C. ChiaYih Yng NgBenjamin S.H. LeongHan Nee GanWei Ming NgSi Oon CheahDesmond R. MaoNausheen EdwinShalini ArulanandamDepartment of Emergency Medicine, Singapore General Hospital, Singapore; Pre-hospital & Emergency Research Centre, Duke-National University of Singapore Medical School, Singapore; Centre for Population Health Research and Implementation, SingHealth Regional Health System, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; Corresponding author. Department of Emergency Medicine, Singapore General Hospital, Outram Rd, 169608, Singapore.Division of Neurosurgery, Department of Surgery, National University Hospital, SingaporeSchool of Public Health and Preventive Medicine, Monash University, Australia; Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, SingaporeDepartment of Family Medicine and Community Health, Duke University School of Medicine, Durham, NC, USA; Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Health Services and Systems Research, Duke-NUS Medical School, SingaporeHealth Services & Systems Research, Duke-NUS Medical School, SingaporeYong Loo Lin School of Medicine, National University of Singapore, SingaporePre-hospital & Emergency Research Centre, Duke-National University of Singapore Medical School, SingaporeAccident & Emergency Department, Changi General Hospital, SingaporeDepartment of Emergency Medicine, Singapore General Hospital, Singapore; Health Services & Systems Research, Duke-NUS Medical School, SingaporeSummary: Background: Understanding the long-term outcomes and disability-adjusted life years (DALY) after out-of-hospital cardiac arrest (OHCA) is important to understand the overall health and disease burden of OHCA respectively, but data in Asia remains limited. We aimed to quantify long-term survival and the annual disease burden of OHCA within a national multi-ethnic Asian cohort. Methods: We conducted an open cohort study linking the Singapore Pan-Asian Resuscitation Outcomes Study (PAROS) and the Singapore Registry of Births and Deaths from 2010 to 2019. We performed Cox regression, constructed Kaplan–Meier curves, and calculated DALYs and standardised mortality ratios (SMR) for each year of follow-up. Results: We analysed 802 cases. The mean age was 56.0 (SD 17.8). Most were male (631 cases, 78,7%) and of Chinese ethnicity (552 cases, 68.8%). At one year, the SMR was 14.9 (95% CI:12.5–17.8), decreasing to 1.2 (95% CI:0.7–1.8) at three years, and 0.4 (95% CI:0.2–0.8) at five years. Age at arrest (HR:1.03, 95% CI:1.02–1.04, p < 0.001), shockable presenting rhythm (HR:0.75, 95% CI:0.52–0.93, p = 0.015) and CPC category (HR:4.62, 95% CI:3.17–6.75, p < 0.001) were independently associated with mortality. Annual DALYs due to OHCA varied from 304.1 in 2010 to 849.7 in 2015, then 547.1 in 2018. Mean DALYs decreased from 12.162 in 2010 to 3.599 in 2018. Conclusions: OHCA survivors had an increased mortality rate for the first three years which subsequently normalised compared to that of the general population. Annual OHCA disease burden in DALY trended downwards from 2010 to 2018. Improved surveillance and OHCA treatment strategies may improve long-term survivorship and decrease its global burden. Funding: National Medical Research Council, Singapore, under the Clinician Scientist Award (NMRC/CSA-SI/0014/2017) and the Singapore Translational Research Investigator Award (MOH-000982-01).http://www.sciencedirect.com/science/article/pii/S2666606522002875Cardiac arrestOut-of-hospital cardiac arrestDisease burdenLong-term survivalMortality |
| spellingShingle | Andrew Fu Wah Ho Mervyn Jun Rui Lim Arul Earnest Audrey Blewer Nicholas Graves Jun Wei Yeo Pin Pin Pek Ling Tiah Marcus Eng Hock Ong Michael Y.C. Chia Yih Yng Ng Benjamin S.H. Leong Han Nee Gan Wei Ming Ng Si Oon Cheah Desmond R. Mao Nausheen Edwin Shalini Arulanandam Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort studyResearch in context The Lancet Regional Health. Western Pacific Cardiac arrest Out-of-hospital cardiac arrest Disease burden Long-term survival Mortality |
| title | Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort studyResearch in context |
| title_full | Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort studyResearch in context |
| title_fullStr | Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort studyResearch in context |
| title_full_unstemmed | Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort studyResearch in context |
| title_short | Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort studyResearch in context |
| title_sort | long term survival and disease burden from out of hospital cardiac arrest in singapore a population based cohort studyresearch in context |
| topic | Cardiac arrest Out-of-hospital cardiac arrest Disease burden Long-term survival Mortality |
| url | http://www.sciencedirect.com/science/article/pii/S2666606522002875 |
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