Key result
Preexisting hemodialysis was not significantly associated with survival to hospital discharge (adjusted OR 1.544) or other survival outcomes in adult patients with out-of-hospital cardiac arrest.
Why the study?
Although sudden cardiac death incidence is higher in hemodialysis patients, whether out-of-hospital cardiac arrest survival outcomes are poorer in this population remains unclear.
Does preexisting hemodialysis worsen survival and neurological outcomes in adult nontraumatic out-of-hospital cardiac arrest patients?
Cohort (n=2,489)
Yes
Does preexisting hemodialysis worsen survival and neurological outcomes in adult nontraumatic out-of-hospital cardiac arrest patients?
Odds Ratio: 1.544 (95% CI 0.734–3.25)
Absolute Event Rate: 17.2% vs 15%
p-value: p=0.252
Preexisting hemodialysis does not appear to be significantly associated with worse survival or neurological outcomes in out-of-hospital cardiac arrest patients, suggesting resuscitation efforts should not be withheld in this population.
Does not support altering resuscitation decisions by hemodialysis status; leaves open the need for larger prospective studies on dialysis-related arrest outcomes.
Background: Although the incidence of sudden cardiac death is higher in hemodialysis (HD) patients, whether out-of-hospital cardiac arrest (OHCA) survival outcomes are poorer in this group remains unclear. This study aimed to assess the impact of HD on survival outcomes among adult nontraumatic OHCA patients and to compare these outcomes between HD and non-HD groups. Methods: This observational cohort study retrospectively analyzed data from adult nontraumatic OHCA patients in Ulsan, South Korea, from January 2017 through December 2022. Multivariable logistic regression analysis was applied to evaluate whether HD was a risk factor for survival in OHCA patients. Survival was compared between the two groups in unadjusted, balanced groups by propensity score matching (PSM) and inverse probability of the treatment weighting (IPWT). Results: -value, 1.648 [0.934-2.907], 0.085), survival to discharge (1.544 [0.734-3.250], 0.252), or neurological outcomes (0.394 [0.017-9.346], 0.564). There were also no significant differences observed in any ROSC (1.648 [0.934-2.907], 0.085), survival to discharge (1.544 [0.734-3.250], 0.252), or favorable neurological outcome (0.394 [0.017-9.346], 0.564) between the two unadjusted groups. The insignificant survival differences were persistently observed in the PSM group and IPWT group. Conclusion: Although HD may pose a risk factor for cardiac arrest, our study did not find a significant association with survival outcomes in OHCA patients. Additionally, no notable survival difference was observed between HD and non-HD groups. Therefore, resuscitation efforts in HD patients should not be underestimated.
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Park et al. (2025) conducted a cohort in Out-of-hospital cardiac arrest (OHCA) (n=2,489). Preexisting hemodialysis vs. Non-hemodialysis was evaluated on Survival to hospital discharge (adjusted OR 1.544, 95% CI 0.734-3.250, p=0.252). Preexisting hemodialysis was not significantly associated with survival to hospital discharge (adjusted OR 1.544) or other survival outcomes in adult patients with out-of-hospital cardiac arrest.
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