Saee Byel Kang1, So Yeon Joyce Kong2, Sang Do Shin3, Young Sun Ro4, Kyoung Jun Song5, Ki Jeong Hong6, Tae Han Kim7. 1. Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: kang.emergency@gmail.com. 2. Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: soyeon.kong@gmail.com. 3. Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: sdshin@snu.ac.kr. 4. Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: Ro.youngsun@gmail.com. 5. Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea; Department of Emergency Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea. Electronic address: skciva@gmail.com. 6. Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: emkjhong@gmail.com. 7. Department of Emergency Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Republic of Korea. Electronic address: adoong2001@gmail.com.
Abstract
OBJECTIVES: There is growing evidence that optimal post-resuscitation treatment is a significant factor for overall survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA). However, there is also growing evidence of disparities in treatments in vulnerable populations such as elderly individuals or patients with underlying diseases, including cancer. AIM: The aim of this study was to evaluate the influence of cancer status on post-resuscitation therapies among OHCA patients. MATERIAL AND METHODS: This was a cross-sectional observational study based on a nationwide prospective OHCA registry database of Korea. All adult OHCA patients with presumed cardiac etiology and sustained return of spontaneous circulation (ROSC) from 2009 to 2016 were included in this study. Main exposure was history of cancer and primary outcome was post-resuscitation care, including percutaneous coronary intervention (PCI) and targeted temperature management (TTM). Multivariable logistic regression was used to analyze the association between cancer and post-resuscitation treatments. RESULTS: A total of 33,760 patients were included for final analysis. Multivariable logistic analysis showed that cancer patients were significantly less likely to receive PCI and TTM compared to those without history of cancer with adjusted odds ratios of 0.29 (95% CI: 0.24-0.37) and 0.66 (0.58-0.77), respectively. CONCLUSION: The results of this study suggest that a prior history of cancer may be associated with lower probability to receive potentially beneficial post-resuscitation treatments.
OBJECTIVES: There is growing evidence that optimal post-resuscitation treatment is a significant factor for overall survival and neurological outcomes in out-of-hospital cardiac arrest (OHCA). However, there is also growing evidence of disparities in treatments in vulnerable populations such as elderly individuals or patients with underlying diseases, including cancer. AIM: The aim of this study was to evaluate the influence of cancer status on post-resuscitation therapies among OHCA patients. MATERIAL AND METHODS: This was a cross-sectional observational study based on a nationwide prospective OHCA registry database of Korea. All adult OHCA patients with presumed cardiac etiology and sustained return of spontaneous circulation (ROSC) from 2009 to 2016 were included in this study. Main exposure was history of cancer and primary outcome was post-resuscitation care, including percutaneous coronary intervention (PCI) and targeted temperature management (TTM). Multivariable logistic regression was used to analyze the association between cancer and post-resuscitation treatments. RESULTS: A total of 33,760 patients were included for final analysis. Multivariable logistic analysis showed that cancerpatients were significantly less likely to receive PCI and TTM compared to those without history of cancer with adjusted odds ratios of 0.29 (95% CI: 0.24-0.37) and 0.66 (0.58-0.77), respectively. CONCLUSION: The results of this study suggest that a prior history of cancer may be associated with lower probability to receive potentially beneficial post-resuscitation treatments.