What is the clinical evidence from this study?

Study design: Cohort. Population: Newly diagnosed cancer (n=5450438). Intervention: Newly diagnosed cancer vs. No cancer. Primary outcome: Occurrence of out-of-hospital cardiac arrest (OHCA) with medical cause (HR 3.18, 95% CI 2.97-3.41, p=<0.01).

What does this research mean for the field?

Newly diagnosed cancer significantly increases the risk of out-of-hospital cardiac arrest compared to individuals without cancer, with the highest relative risk observed in younger adults and specific cancer types. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

February 19, 2025Open Access

Out-of-hospital cardiac arrest event after cancer diagnosis: a korean metropolitan cohort study

Q: What are the key findings of this study?

Newly diagnosed cancer significantly increased the risk of out-of-hospital cardiac arrest compared to individuals without cancer (HR 3.18).

Q: What does this research mean for the field?

Newly diagnosed cancer significantly increases the risk of out-of-hospital cardiac arrest compared to individuals without cancer, with the highest relative risk observed in younger adults and specific cancer types. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Key Result

Newly diagnosed cancer significantly increased the risk of out-of-hospital cardiac arrest compared to individuals without cancer (HR 3.18).

Study Design

Type

Cohort (n=5,450,438)

Structured PICO

Does newly diagnosed cancer increase the risk of out-of-hospital cardiac arrest in adults aged 40 years or older?

Population

5,450,438 adults aged 40 years or older residing in Seoul, South Korea, with no history of cancer or out-of-hospital cardiac arrest (OHCA) at baseline.

Intervention

Newly diagnosed cancer (exposure)

Comparator

No cancer diagnosis (non-cancer group)

Outcome

Occurrence of out-of-hospital cardiac arrest (OHCA) with a medical causehard clinical

Newly diagnosed cancer is associated with a more than threefold increased risk of out-of-hospital cardiac arrest, highlighting the need for proactive cardiovascular risk assessment in oncology patients.

Main Result

Effect estimate: HR 3.18 (95% CI 2.97-3.41)

Absolute Event Rate: 145% vs 54%

p-value: p=<0.01

Limitations

Accuracy of the cancer diagnosis cannot be measured directly
Cancer stage and treatment status were not analyzed
Maximum follow-up of 4 years is relatively short for slow-growing cancers
In-hospital cardiac arrests and cases without resuscitation were excluded
Unmeasured confounders such as lifestyle factors (smoking, alcohol) and obesity
Conducted in a single metropolitan city, limiting generalizability

Abstract

BACKGROUND: The importance of assessing out-of-hospital cardiac arrest (OHCA) risk in cancer patients is increasing as cancer incidence rises in aging populations. OBJECTIVE: This study aimed to investigate the association between newly diagnosed cancer and OHCA risk using a metropolitan cohort from South Korea. METHODS: A population-based retrospective cohort study was conducted, linking the nationwide OHCA registry with the National Health Information Database. The study included adults aged 40 years or older, residing in Seoul between 2015 and 2018, with no history of cancer or OHCA. The main exposure was cancer development. The primary outcome was the occurrence of OHCA with medical cause. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were calculated using a cause-specific hazard model considering death as a competing risk. Analyses stratified by age group and cancer type were also conducted. RESULTS: During a follow-up period of up to 4 years for 5,450,438 individuals, 174,785 participants developed cancer. The incidence rates of OHCA per 100,000 person-years were 54.0 in non-cancer and 145.0 in cancer groups, respectively. The aHR (95% CI) for OHCA associated with cancer development was 3.18 (2.97-3.41). The aHR (95% CI) for OHCA was highest in the 40-49 years of age group (7.52 5.52-10.25), followed by 50-59 years old (6.66 5.56-7.97) compared to older age groups. By cancer type, pancreatic, lung, biliary tract, and liver cancer were associated with a significantly increased risk of OHCA. CONCLUSION: We found an association between newly diagnosed cancer and the occurrence of OHCA. Our findings underscore the importance of tailored risk assessments and proactive care planning for patients with cancer.

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