Comorbidities prior to out-of-hospital cardiac arrest and diagnoses at discharge among survivors
Background Out-of-hospital cardiac arrest (OHCA) has a dismal prognosis with overall survival around 10%. Previous studies have shown conflicting results regarding the prevalence and significance of comorbidities in OHCA, as well as the underlying causes. Previously, 80% of sudden cardiac arrest hav...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-11-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/10/2/e002308.full |
| _version_ | 1797316006728695808 |
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| author | Truls Råmunddal Araz Rawshani Nellie Hjärtstam Gustaf Hellsén |
| author_facet | Truls Råmunddal Araz Rawshani Nellie Hjärtstam Gustaf Hellsén |
| author_sort | Truls Råmunddal |
| collection | DOAJ |
| description | Background Out-of-hospital cardiac arrest (OHCA) has a dismal prognosis with overall survival around 10%. Previous studies have shown conflicting results regarding the prevalence and significance of comorbidities in OHCA, as well as the underlying causes. Previously, 80% of sudden cardiac arrest have been attributed to coronary artery disease. We studied comorbidities and discharge diagnoses in OHCA in all of Sweden.Methods We used the Swedish Registry of Cardiopulmonary Resuscitation, merged with the Inpatient Registry and Outpatient Registry to identify patients with OHCA from 2010 to 2020 and to collect all their comorbidities as well as discharge diagnoses (among those admitted to hospital). Patient characteristics were described using means, medians and SD. Survival curves were performed among hospitalised patients with acute myocardial infarction (AMI) as well as heart failure.Results A total of 54 484 patients with OHCA were included, of whom 35 894 (66%) were men. The most common comorbidities prior to OHCA were hypertension (43.6%), heart failure (23.6%), chronic ischaemic heart disease (23.6%) and atrial fibrillation (22.0%). Previous AMI was prevalent in 14.8% of men and 10.9% of women. Among women, 18.0% had type 2 diabetes, compared with 19.6% of the men. Among hospitalised patients, 30% were diagnosed with AMI, 27% with hypertension, 20% with ischaemic heart disease and 18% with heart failure as discharge diagnoses.Conclusion In summary, we find evidence that nowadays a minority of cardiac arrests are due to coronary artery disease and AMIs and its complications. Only 30% of all cases of OHCA admitted to hospital were diagnosed with AMI. Coronary artery disease is now likely in the minority with regard to causes of OHCA. |
| first_indexed | 2024-03-08T03:13:05Z |
| format | Article |
| id | doaj.art-bcf58b69525e41c28e4fa4241b44e8d0 |
| institution | Directory Open Access Journal |
| issn | 2053-3624 |
| language | English |
| last_indexed | 2024-03-08T03:13:05Z |
| publishDate | 2023-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj.art-bcf58b69525e41c28e4fa4241b44e8d02024-02-13T03:55:08ZengBMJ Publishing GroupOpen Heart2053-36242023-11-0110210.1136/openhrt-2023-002308Comorbidities prior to out-of-hospital cardiac arrest and diagnoses at discharge among survivorsTruls Råmunddal0Araz Rawshani1Nellie Hjärtstam2Gustaf Hellsén3Department of Molecular and Clinical Medicine, University of Gothenburg, Goteborg, SwedenDepartment of Molecular and Clinical Medicine, University of Gothenburg, Goteborg, SwedenDepartment of Molecular and Clinical Medicine, University of Gothenburg, Goteborg, SwedenDepartment of Molecular and Clinical Medicine, University of Gothenburg, Goteborg, SwedenBackground Out-of-hospital cardiac arrest (OHCA) has a dismal prognosis with overall survival around 10%. Previous studies have shown conflicting results regarding the prevalence and significance of comorbidities in OHCA, as well as the underlying causes. Previously, 80% of sudden cardiac arrest have been attributed to coronary artery disease. We studied comorbidities and discharge diagnoses in OHCA in all of Sweden.Methods We used the Swedish Registry of Cardiopulmonary Resuscitation, merged with the Inpatient Registry and Outpatient Registry to identify patients with OHCA from 2010 to 2020 and to collect all their comorbidities as well as discharge diagnoses (among those admitted to hospital). Patient characteristics were described using means, medians and SD. Survival curves were performed among hospitalised patients with acute myocardial infarction (AMI) as well as heart failure.Results A total of 54 484 patients with OHCA were included, of whom 35 894 (66%) were men. The most common comorbidities prior to OHCA were hypertension (43.6%), heart failure (23.6%), chronic ischaemic heart disease (23.6%) and atrial fibrillation (22.0%). Previous AMI was prevalent in 14.8% of men and 10.9% of women. Among women, 18.0% had type 2 diabetes, compared with 19.6% of the men. Among hospitalised patients, 30% were diagnosed with AMI, 27% with hypertension, 20% with ischaemic heart disease and 18% with heart failure as discharge diagnoses.Conclusion In summary, we find evidence that nowadays a minority of cardiac arrests are due to coronary artery disease and AMIs and its complications. Only 30% of all cases of OHCA admitted to hospital were diagnosed with AMI. Coronary artery disease is now likely in the minority with regard to causes of OHCA.https://openheart.bmj.com/content/10/2/e002308.full |
| spellingShingle | Truls Råmunddal Araz Rawshani Nellie Hjärtstam Gustaf Hellsén Comorbidities prior to out-of-hospital cardiac arrest and diagnoses at discharge among survivors Open Heart |
| title | Comorbidities prior to out-of-hospital cardiac arrest and diagnoses at discharge among survivors |
| title_full | Comorbidities prior to out-of-hospital cardiac arrest and diagnoses at discharge among survivors |
| title_fullStr | Comorbidities prior to out-of-hospital cardiac arrest and diagnoses at discharge among survivors |
| title_full_unstemmed | Comorbidities prior to out-of-hospital cardiac arrest and diagnoses at discharge among survivors |
| title_short | Comorbidities prior to out-of-hospital cardiac arrest and diagnoses at discharge among survivors |
| title_sort | comorbidities prior to out of hospital cardiac arrest and diagnoses at discharge among survivors |
| url | https://openheart.bmj.com/content/10/2/e002308.full |
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