Pre-existing psychiatric disorders were associated with lower odds of 30-day survival following out-of-hospital cardiac arrest (OR 0.72; 95% CI 0.63-0.82).
Cohort (n=9,173)
Yes
Does a pre-existing psychiatric disorder reduce 30-day survival in adult patients with out-of-hospital cardiac arrest?
Pre-existing psychiatric disorders are associated with lower 30-day survival after out-of-hospital cardiac arrest, largely driven by unfavorable pre-hospital factors such as limited bystander intervention.
Odds Ratio: 0.72 (95% CI 0.63–0.82)
BACKGROUND: Current literature lacks comprehensive data on the characteristics and outcomes of out-of-hospital cardiac arrest (OHCA) in patients with psychiatric disorders. OBJECTIVE: To assess the association between pre-hospital OHCA-characteristics and post-OHCA survival according to pre-OHCA psychiatric status. METHODS: We classified adult patients with non-traumatic OHCA in the British Columbia Cardiac Arrest registry (2009-2016) according to whether they had a pre-OHCA psychiatric disorder. We used multiple logistic regression, examining the full cohort and within Utstein-defined subgroups. RESULTS: Among 9173 OHCAs (median age 70 years, 67% male), 4438 (46%) had a pre-existing psychiatric disorder. In adjusted analyses, patients with psychiatric disorders were associated with lower odds of OHCA in public locations (odds ratio OR: 0.64, 95% confidence interval CI, 0.57-0.73), witnessed OHCA (OR: 0.75 CI, 0.69-0.82), bystander cardiopulmonary resuscitation (OR: 0.86 CI, 0.79-0.95), bystander applied AED (OR: 0.56 CI, 0.41-0.77) or initial shockable rhythm (OR: 0.54 CI, 0.49-0.61) compared with patients without psychiatric disorders. Psychiatric disorders were associated with lower odds of 30-day post-OHCA survival (OR: 0.72, CI, 0.63-0.82) compared with patients without psychiatric disorders. However, among those with bystander-witnessed OHCA who received cardiopulmonary resuscitation (OR: 1.04 CI, 0.79-1.34) and those with initial shockable rhythm who achieved return of spontaneous circulation upon hospital arrival (OR: 0.89 CI, 0.70-1.13), we did not detect an association between psychiatric disorders and 30-day survival. CONCLUSION: Pre-existing psychiatric disorders are associated with lower odds of 30-day OHCA survival, primarily because of unfavorable pre-hospital factors, including limited bystander intervention.
Barcella et al. (Fri,) conducted a cohort in Out-of-hospital cardiac arrest (n=9,173). Pre-existing psychiatric disorders vs. No psychiatric disorders was evaluated on 30-day post-OHCA survival (OR 0.72, 95% CI 0.63-0.82). Pre-existing psychiatric disorders were associated with lower odds of 30-day survival following out-of-hospital cardiac arrest (OR 0.72; 95% CI 0.63-0.82).