Marianne Pape1, Shahzleen Rajan2, Steen Møller Hansen3, Rikke Nørmark Mortensen3, Signe Riddersholm4, Fredrik Folke5, Lena Karlsson5, Freddy Lippert6, Lars Køber7, Gunnar Gislason8, Helle Søholm9, Mads Wissenberg5, Thomas A Gerds10, Christian Torp-Pedersen11, Kristian Kragholm12. 1. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; Department of Anesthesiology and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark. Electronic address: marianne.pape@rn.dk. 2. Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark. 3. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark. 4. Department of Anesthesiology and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark. 5. Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark; Emergency Medical Services Copenhagen, University of Copenhagen, Ballerup, Denmark. 6. Emergency Medical Services Copenhagen, University of Copenhagen, Ballerup, Denmark. 7. Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. 8. Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark; The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; The Danish Heart Foundation, Copenhagen, Denmark. 9. Department of Cardiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Cardiology, University Hospital Zealand, Roskilde, Denmark. 10. The Danish Heart Foundation, Copenhagen, Denmark; Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark. 11. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; The Institute of Health Science and Technology, Aalborg University, Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark. 12. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
Abstract
BACKGROUND: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents. METHODS: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival. Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately. RESULTS: Of 26,999 OCHAs, 2516 (9.3%) occurred in nursing homes, and 24,483 (90.7%) in private homes. Nursing home residents were older (median 83 (Q1-Q3: 75-89) vs. 71 (Q1-Q3: 61-80) years), had more witnessed arrest (55.4% vs. 43.4%), received more bystander cardiopulmonary resuscitation (CPR) (49.7% vs. 35.3%), but less pre-hospital defibrillation (15.1% vs. 29.8%). Registered AEDs increased in the period 2007-2014 from 1 to 211 in nursing homes vs. 1 to 488 in private homes. Average 30-day survival in nursing homes was 1.7% [95%CI: 1.2-2.2%] vs. 4.9% [95%CI: 4.6-5.2%] in private homes (P < 0.001). If bystanders witnessed the arrest, performed CPR, and pre-hospital defibrillation was performed, 30-day survival was 7.7% [95%CI: 3.5-11.9%] vs. 24.2% [95%CI: 22.5-25.9%] in nursing vs. private home residents. CONCLUSIONS: Average 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival.
BACKGROUND: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents. METHODS: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival. Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately. RESULTS: Of 26,999 OCHAs, 2516 (9.3%) occurred in nursing homes, and 24,483 (90.7%) in private homes. Nursing home residents were older (median 83 (Q1-Q3: 75-89) vs. 71 (Q1-Q3: 61-80) years), had more witnessed arrest (55.4% vs. 43.4%), received more bystander cardiopulmonary resuscitation (CPR) (49.7% vs. 35.3%), but less pre-hospital defibrillation (15.1% vs. 29.8%). Registered AEDs increased in the period 2007-2014 from 1 to 211 in nursing homes vs. 1 to 488 in private homes. Average 30-day survival in nursing homes was 1.7% [95%CI: 1.2-2.2%] vs. 4.9% [95%CI: 4.6-5.2%] in private homes (P < 0.001). If bystanders witnessed the arrest, performed CPR, and pre-hospital defibrillation was performed, 30-day survival was 7.7% [95%CI: 3.5-11.9%] vs. 24.2% [95%CI: 22.5-25.9%] in nursing vs. private home residents. CONCLUSIONS: Average 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival.
Authors: Amy Vogelsmeier; Lori Popejoy; Elizabeth Fritz; Kelli Canada; Bin Ge; Lea Brandt; Marilyn Rantz Journal: BMC Health Serv Res Date: 2022-05-10 Impact factor: 2.908