What question did this study set out to answer?

The research aims to investigate differences in health care utilization prior to out-of-hospital cardiac arrest based on whether arrest rhythms are shockable or non-shockable.

March 28, 2026Open Access

Differences in Health Care Utilization Prior to Cardiac Arrest By Shockable and Non-Shockable Presenting Rhythms: A Case Control Study

Key Points

The research aims to investigate differences in health care utilization prior to out-of-hospital cardiac arrest based on whether arrest rhythms are shockable or non-shockable.
Matched case-control study using the British Columbia Cardiac Arrest Registry.
Identified cardiac arrests from 2009-2019.
Matched patients based on age, sex, and geographic population.
Assessed hospital admissions and emergency department visits in the 3 years prior to arrest.
Analyzed both cardiovascular and non-cardiovascular health encounters.
61.2% of patients with shockable rhythms had healthcare encounters compared to 48.8% of controls (OR 1.74).
74.8% of patients with non-shockable rhythms had healthcare encounters compared to 50.6% of controls (OR 3.13).
Both groups showed increased biweekly rates of health care visits leading up to cardiac arrest, particularly between 6-24 weeks prior.
Higher rates of cardiovascular encounters were noted, with non-shockable arrests exhibiting more non-cardiovascular encounters.

Abstract

Background: Health care utilization has been shown to increase prior to out-of-hospital cardiac arrest (OHCA).However, differences between OHCA presenting with shockable and nonshockable rhythms have not been explored.Objective: We examined differences in health care utilization prior to OHCA among patients with shockable and non-shockable rhythms.Methods: This was a matched case-control study.Cardiac arrests from 2009-2019 were identified in the British Columbia (BC) Cardiac Arrest Registry.Age, sex and geographic population-matched controls were identified.Primary outcomes were hospital admissions or emergency department (ED) visits 3 years prior to arrest.Secondary outcomes included cardiovascular (CV) and non-CV encounters.Results: A total of 3461 shockable and 11,470 non-shockable OHCA patients were matched 4:1 to controls.Hospitalization or ED visit in the 3 years prior was 61.2% in the shockable group (48.8% in controls, OR 1.74, 95% CI 1.60-1.88)and 74.8% in the non-shockable group (50.6% in controls, OR 3.13, 95% CI 2.99-3.29).All health care encounters (hospitalization, ED or outpatient visits) were more common in both shockable and non-shockable cardiac arrests, with a higher rate of CV encounters .Non-shockable cardiac arrests had higher relative rates of non-CV encounters.Biweekly rates of hospital and emergency visits leading up to OHCA were increased for both groups, rising at 6-24 weeks prior to arrest. Conclusion and Relevance:Shockable and non-shockable OHCA show high rates of health care utilization prior to cardiac arrest.However, there were important differences in health care utilization between the shockable and non-shockable groups.

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