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Cardiac Arrest Following Drug Overdose in the United States: An Analysis of the Cardiac Arrest Registry to Enhance Survival.
Shekhar, Aditya C; Nathanson, Brian H; Mader, Timothy J; Coute, Ryan A.
Afiliación
  • Shekhar AC; The Icahn School of Medicine at Mount Sinai New York NY USA.
  • Nathanson BH; OptiStatim, LLC Longmeadow MA USA.
  • Mader TJ; Department of Emergency Medicine UMass Chan Medical School-Baystate Springfield MA USA.
  • Coute RA; Department of Healthcare Delivery and Population Science UMass Chan Medical School-Baystate Springfield MA USA.
J Am Heart Assoc ; 13(3): e031245, 2024 Feb 06.
Article en En | MEDLINE | ID: mdl-38293840
ABSTRACT

BACKGROUND:

Given increases in drug overdose-associated mortality, there is interest in better understanding of drug overdose out-of-hospital cardiac arrest (OHCA). A comparison between overdose-attributable OHCA and nonoverdose-attributable OHCA will inform public health measures. METHODS AND

RESULTS:

We analyzed data from 2017 to 2021 in the Cardiac Arrest Registry to Enhance Survival (CARES), comparing overdose-attributable OHCA (OD-OHCA) with OHCA from other nontraumatic causes (non-OD-OHCA). Arrests involving patients <18 years, health care facility residents, patients with cancer diagnoses, and patients with select missing data were excluded. Our main outcome of interest was survival with good neurological outcome, defined as Cerebral Performance Category score 1 or 2. From a data set with 537 100 entries, 29 500 OD-OHCA cases and 338 073 non-OD-OHCA cases met inclusion criteria. OD-OHCA cases involved younger patients with fewer comorbidities, were less likely to be witnessed, and less likely to present with a shockable rhythm. Unadjusted survival to hospital discharge with Cerebral Performance Category score =1 or 2 was significantly higher in the OD-OHCA cohort (OD 15.2% versus non-OD 6.9%). Adjusted results showed comparable survival with Cerebral Performance Category score =1 or 2 when the first monitored arrest rhythm was shockable (OD 28.9% versus non-OD 23.5%, P=0.087) but significantly higher survival rates with Cerebral Performance Category score =1 or 2 for OD-OHCA when the first monitored arrest rhythm was nonshockable (OD 9.6% versus non-OD 3.1%, P<0.001).

CONCLUSIONS:

Among patients presenting with nonshockable rhythms, OD-OHCA is associated with significantly better outcomes. Further research should explore cardiac arrest causes, and public health efforts should attempt to reduce the burden from drug overdoses.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reanimación Cardiopulmonar / Servicios Médicos de Urgencia / Paro Cardíaco Extrahospitalario / Sobredosis de Droga Tipo de estudio: Diagnostic_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: J Am Heart Assoc Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Reanimación Cardiopulmonar / Servicios Médicos de Urgencia / Paro Cardíaco Extrahospitalario / Sobredosis de Droga Tipo de estudio: Diagnostic_studies Límite: Humans País/Región como asunto: America do norte Idioma: En Revista: J Am Heart Assoc Año: 2024 Tipo del documento: Article Pais de publicación: Reino Unido