Key result
Dialysis history shows no link to survival to hospital admission after OHCA.
Why the study?
To assess whether a history of dialysis is related to CPR attempts and survival to hospital admission in patients with out-of-hospital cardiac arrest.
Does a history of dialysis affect the rate of CPR attempts and survival to hospital admission in patients with out-of-hospital cardiac arrest?
Observational (n=26,783)
Yes
Does a history of dialysis affect the rate of CPR attempts and survival to hospital admission in patients with out-of-hospital cardiac arrest?
Odds Ratio: 1.12 (95% CI 0.74–1.7)
Absolute Event Rate: 36.9% vs 36.3%
p-value: p=0.60
A history of dialysis does not negatively impact the likelihood of CPR attempts or short-term survival to hospital admission in OHCA patients, despite less frequent use of defibrillation.
Dialysis history was not associated with survival to admission after out-of-hospital cardiac arrest; hypothesis-generating and should not yet change practice.
PURPOSE: The aim of the study was to assess whether a history of dialysis is related to cardiopulmonary resuscitation (CPR) attempts and survival to hospital admission in patients with out-of-hospital cardiac arrest (OHCA). METHODS: The databases of the POL-OHCA registry and of emergency medical calls in the Command Support System of the State of Emergency Medicine (CSS) were searched to identify patients with OHCA and a history of dialysis. A total of 264 dialysis patient with OHCA were found: 126 were dead on arrival of emergency medical services (EMS), and 138 had OHCA with CPR attempts. Data from the POL-OHCA registry for patients with CPR attempts, including age, sex, place of residence, first recorded rhythm, defibrillation during CPR, and priority dispatch codes, were collected and compared between patients with and without dialysis. RESULTS: CPR attempts by EMS were undertaken in 138 dialyzed patients (52.3%). The analysis of POL-OHCA data revealed no differences in age, sex, place of residence, first recorded rhythm, and priority dispatch codes between patients with and without dialysis. Defibrillation was less frequent in dialysis patients (P = 0.04). A stepwise logistic regression analysis revealed no association between survival to hospital admission and a history of hemodialysis (odds ratio = 1.12; 95% CI 0.74-1.70, P = 0.60). CONCLUSIONS: A history of dialysis in patients with OHCA does not affect the rate of CPR attempts by EMS or a short-term outcome in comparison with patients without dialysis. Defibrillation during CPR is less common in patients on dialysis than in those without.
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Obremska et al. (2020) conducted an observational in Out-of-hospital cardiac arrest (n=26,783). History of dialysis vs. No history of dialysis was evaluated on Survival to hospital admission or HEMS transport (OR 1.12, 95% CI 0.74-1.70, p=0.60). A history of dialysis in patients with out-of-hospital cardiac arrest did not significantly affect survival to hospital admission compared to patients without dialysis (OR 1.12, 95% CI 0.74-1.70, p=0.60).
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