Carlo Alberto Barcella1, Grimur H Mohr2, Kristian Kragholm3, Paul Blanche4, Thomas A Gerds5, Mads Wissenberg6, Steen M Hansen7, Kristian Bundgaard8, Freddy K Lippert9, Fredrik Folke6, Christian Torp-Pedersen10, Lars V Kessing11, Gunnar H Gislason12, Kathrine B Søndergaard13. 1. Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark. Electronic address: carlo.alberto.barcella@regionh.dk. 2. Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark; Psychiatric Center Amager, Copenhagen University Hospital, Copenhagen, Denmark. 3. Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark. 4. Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark; Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 5. Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark; The Danish Heart Foundation, Copenhagen, Denmark. 6. Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark; Emergency Medical Services: The Capital Region of Denmark, Ballerup, Denmark. 7. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark. 8. Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark. 9. Emergency Medical Services: The Capital Region of Denmark, Ballerup, Denmark. 10. Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark; Departments of Clinical Investigation and Cardiology, Nordsjaellands Hospital, Hillerød, Denmark. 11. Psychiatric Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark. 12. Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark; The Danish Heart Foundation, Copenhagen, Denmark. 13. Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark.
Abstract
AIMS: To investigate whether the recent improvements in pre-hospital cardiac arrest-management and survival following out-of-hospital cardiac arrest (OHCA) also apply to OHCA patients with psychiatric disorders. METHODS: We identified all adult Danish patients with OHCA of presumed cardiac cause, 2001-2015. Psychiatric disorders were defined by hospital diagnoses up to 10 years before OHCA and analyzed as one group as well as divided into five subgroups (schizophrenia-spectrum disorders, bipolar disorder, depression, substance-induced mental disorders, other psychiatric disorders). Association between psychiatric disorders and pre-hospital OHCA-characteristics and 30-day survival were assessed by multiple logistic regression. RESULTS: Of 27,523 OHCA-patients, 4772 (17.3%) had a psychiatric diagnosis. Patients with psychiatric disorders had lower odds of 30-day survival (0.37 95% confidence interval 0.32-0.43) compared with other OHCA-patients. Likewise, they had lower odds of witnessed status (0.75 CI 0.70-0.80), bystander cardiopulmonary resuscitation (CPR) (0.77 CI 0.72-0.83), shockable heart rhythm (0.37 95% CI, 0.33-0.40), and return of spontaneous circulation (ROSC) at hospital arrival (0.66 CI 0.59-0.72). Similar results were seen in all five psychiatric subgroups. The difference in 30-day survival between patients with and without psychiatric disorders increased in recent years: from 8.4% (CI 7.0-10.0%) in 2006 to 13.9% (CI 12.4-15.4%) in 2015 and from 7.0% (4.3-10.8%) in 2006 to 7.0% (CI 4.5-9.7%) in 2015, respectively. CONCLUSION: Patients with psychiatric disorders have lower survival following OHCA compared to non-psychiatric patients and the gap between the two groups has widened over time.
AIMS: To investigate whether the recent improvements in pre-hospital cardiac arrest-management and survival following out-of-hospital cardiac arrest (OHCA) also apply to OHCA patients with psychiatric disorders. METHODS: We identified all adult Danish patients with OHCA of presumed cardiac cause, 2001-2015. Psychiatric disorders were defined by hospital diagnoses up to 10 years before OHCA and analyzed as one group as well as divided into five subgroups (schizophrenia-spectrum disorders, bipolar disorder, depression, substance-induced mental disorders, other psychiatric disorders). Association between psychiatric disorders and pre-hospital OHCA-characteristics and 30-day survival were assessed by multiple logistic regression. RESULTS: Of 27,523 OHCA-patients, 4772 (17.3%) had a psychiatric diagnosis. Patients with psychiatric disorders had lower odds of 30-day survival (0.37 95% confidence interval 0.32-0.43) compared with other OHCA-patients. Likewise, they had lower odds of witnessed status (0.75 CI 0.70-0.80), bystander cardiopulmonary resuscitation (CPR) (0.77 CI 0.72-0.83), shockable heart rhythm (0.37 95% CI, 0.33-0.40), and return of spontaneous circulation (ROSC) at hospital arrival (0.66 CI 0.59-0.72). Similar results were seen in all five psychiatric subgroups. The difference in 30-day survival between patients with and without psychiatric disorders increased in recent years: from 8.4% (CI 7.0-10.0%) in 2006 to 13.9% (CI 12.4-15.4%) in 2015 and from 7.0% (4.3-10.8%) in 2006 to 7.0% (CI 4.5-9.7%) in 2015, respectively. CONCLUSION:Patients with psychiatric disorders have lower survival following OHCA compared to non-psychiatricpatients and the gap between the two groups has widened over time.
Authors: Gabriel G Edwards; Audrey Uy-Evanado; Eric C Stecker; Angelo Salvucci; Jonathan Jui; Sumeet S Chugh; Kyndaron Reinier Journal: Int J Cardiol Heart Vasc Date: 2022-04-08