Survival after out-of-hospital cardiac arrest in nursing homes – A nationwide study

Marianne Pape; Shahzleen Rajan; Steen Møller Hansen; Rikke Nørmark Mortensen; Signe Riddersholm; Fredrik Folke; Lena Karlsson; Freddy Lippert; Lars Køber; Gunnar Gislason; Helle Søholm; Mads Wissenberg; Thomas A. Gerds; Christian Torp-Pedersen; Kristian Kragholm

doi:10.1016/j.resuscitation.2018.02.004

Survival after out-of-hospital cardiac arrest in nursing homes – A nationwide study

Marianne Pape^*
, Shahzleen Rajan
, Steen Møller Hansen
, Rikke Nørmark Mortensen
, Signe Riddersholm
, Fredrik Folke
, Lena Karlsson
, Freddy Lippert
, Lars Køber
, Gunnar Gislason
, Helle Søholm
, Mads Wissenberg
, Thomas A. Gerds
, Christian Torp-Pedersen
, Kristian Kragholm

^*Kontaktforfatter

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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Abstract

BACKGROUND: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents.

METHODS: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival. Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately.

RESULTS: Of 26,999 OCHAs, 2516 (9.3%) occurred in nursing homes, and 24,483 (90.7%) in private homes. Nursing home residents were older (median 83 (Q1-Q3: 75-89) vs. 71 (Q1-Q3: 61-80) years), had more witnessed arrest (55.4% vs. 43.4%), received more bystander cardiopulmonary resuscitation (CPR) (49.7% vs. 35.3%), but less pre-hospital defibrillation (15.1% vs. 29.8%). Registered AEDs increased in the period 2007-2014 from 1 to 211 in nursing homes vs. 1 to 488 in private homes. Average 30-day survival in nursing homes was 1.7% [95%CI: 1.2-2.2%] vs. 4.9% [95%CI: 4.6-5.2%] in private homes (P < 0.001). If bystanders witnessed the arrest, performed CPR, and pre-hospital defibrillation was performed, 30-day survival was 7.7% [95%CI: 3.5-11.9%] vs. 24.2% [95%CI: 22.5-25.9%] in nursing vs. private home residents.

CONCLUSIONS: Average 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival.

Originalsprog	Engelsk
Tidsskrift	Resuscitation
Vol/bind	125
Sider (fra-til)	90-98
ISSN	0300-9572
DOI	https://doi.org/10.1016/j.resuscitation.2018.02.004
Status	Udgivet - apr. 2018

Finansiering

The Danish Cardiac Arrest Register, and the Automated External Defibrillator (AED) Network are supported by the Danish Foundation, TrygFonden . Dr. Rajan, Dr. Hansen, Dr. Karlsson, and Dr. Søholm received financial support from TrygFonden. Dr. Hansen has received grants from the Danish Heart Foundation and the Laerdal Foundation . Dr. Kragholm has received grants from the Laerdal Foundation and speaker’s honoraria from Novartis. Dr. Gislason is supported by an unrestricted clinical research scholarship from the Novo Nordisk Foundation . Dr. Folke and Dr. Lippert have both received unrestricted funding from The Laerdal Foundation. All other authors received no financial support. None of these institutions had any influence on study design, data collection and analysis, decision to publish or preparation and approval of the manuscript, and all opinions, results, and conclusions in this paper are solely representative of the authors.

Dokumenter og links

10.1016/j.resuscitation.2018.02.004

Survival after Out-of-Hospital Cardiac Arrest in Nursing Homes – A Nationwide StudyAccepteret manuskript, 780 KBLicens: CC BY-NC-ND

SDU link

Tjek adgangen til materialet i Syddansk Universitetsbiblioteks søgemaskine

Citationsformater

Pape, M., Rajan, S., Hansen, S. M., Mortensen, R. N., Riddersholm, S., Folke, F., Karlsson, L., Lippert, F., Køber, L., Gislason, G., Søholm, H., Wissenberg, M., Gerds, T. A., Torp-Pedersen, C., & Kragholm, K. (2018). Survival after out-of-hospital cardiac arrest in nursing homes – A nationwide study. Resuscitation, 125, 90-98. https://doi.org/10.1016/j.resuscitation.2018.02.004

@article{b5bdeda82ccf4e7e8fd3e6817a2aeece,

title = "Survival after out-of-hospital cardiac arrest in nursing homes – A nationwide study",

abstract = "BACKGROUND: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents.METHODS: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival. Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately.RESULTS: Of 26,999 OCHAs, 2516 (9.3\%) occurred in nursing homes, and 24,483 (90.7\%) in private homes. Nursing home residents were older (median 83 (Q1-Q3: 75-89) vs. 71 (Q1-Q3: 61-80) years), had more witnessed arrest (55.4\% vs. 43.4\%), received more bystander cardiopulmonary resuscitation (CPR) (49.7\% vs. 35.3\%), but less pre-hospital defibrillation (15.1\% vs. 29.8\%). Registered AEDs increased in the period 2007-2014 from 1 to 211 in nursing homes vs. 1 to 488 in private homes. Average 30-day survival in nursing homes was 1.7\% [95\%CI: 1.2-2.2\%] vs. 4.9\% [95\%CI: 4.6-5.2\%] in private homes (P < 0.001). If bystanders witnessed the arrest, performed CPR, and pre-hospital defibrillation was performed, 30-day survival was 7.7\% [95\%CI: 3.5-11.9\%] vs. 24.2\% [95\%CI: 22.5-25.9\%] in nursing vs. private home residents.CONCLUSIONS: Average 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival.",

keywords = "Defibrillation, Nursing home, Out-of-hospital cardiac arrest, Resuscitation, Survival, Nursing Homes/statistics \& numerical data, Cross-Sectional Studies, Time-to-Treatment, Comorbidity, Humans, Middle Aged, Homes for the Aged/statistics \& numerical data, Male, Cardiopulmonary Resuscitation/statistics \& numerical data, Emergency Medical Services/statistics \& numerical data, Aged, 80 and over, Denmark, Female, Registries, Aged, Defibrillators/statistics \& numerical data, Population Surveillance, Out-of-Hospital Cardiac Arrest/mortality",

author = "Marianne Pape and Shahzleen Rajan and Hansen, \{Steen M{\o}ller\} and Mortensen, \{Rikke N{\o}rmark\} and Signe Riddersholm and Fredrik Folke and Lena Karlsson and Freddy Lippert and Lars K{\o}ber and Gunnar Gislason and Helle S{\o}holm and Mads Wissenberg and Gerds, \{Thomas A.\} and Christian Torp-Pedersen and Kristian Kragholm",

year = "2018",

month = apr,

doi = "10.1016/j.resuscitation.2018.02.004",

language = "English",

volume = "125",

pages = "90--98",

journal = "Resuscitation",

issn = "0300-9572",

publisher = "Elsevier",

}

Pape, M, Rajan, S, Hansen, SM, Mortensen, RN, Riddersholm, S, Folke, F, Karlsson, L, Lippert, F, Køber, L, Gislason, G, Søholm, H, Wissenberg, M, Gerds, TA, Torp-Pedersen, C & Kragholm, K 2018, 'Survival after out-of-hospital cardiac arrest in nursing homes – A nationwide study', Resuscitation, bind 125, s. 90-98. https://doi.org/10.1016/j.resuscitation.2018.02.004

TY - JOUR

T1 - Survival after out-of-hospital cardiac arrest in nursing homes – A nationwide study

AU - Pape, Marianne

AU - Rajan, Shahzleen

AU - Hansen, Steen Møller

AU - Mortensen, Rikke Nørmark

AU - Riddersholm, Signe

AU - Folke, Fredrik

AU - Karlsson, Lena

AU - Lippert, Freddy

AU - Køber, Lars

AU - Gislason, Gunnar

AU - Søholm, Helle

AU - Wissenberg, Mads

AU - Gerds, Thomas A.

AU - Torp-Pedersen, Christian

AU - Kragholm, Kristian

PY - 2018/4

Y1 - 2018/4

N2 - BACKGROUND: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents.METHODS: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival. Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately.RESULTS: Of 26,999 OCHAs, 2516 (9.3%) occurred in nursing homes, and 24,483 (90.7%) in private homes. Nursing home residents were older (median 83 (Q1-Q3: 75-89) vs. 71 (Q1-Q3: 61-80) years), had more witnessed arrest (55.4% vs. 43.4%), received more bystander cardiopulmonary resuscitation (CPR) (49.7% vs. 35.3%), but less pre-hospital defibrillation (15.1% vs. 29.8%). Registered AEDs increased in the period 2007-2014 from 1 to 211 in nursing homes vs. 1 to 488 in private homes. Average 30-day survival in nursing homes was 1.7% [95%CI: 1.2-2.2%] vs. 4.9% [95%CI: 4.6-5.2%] in private homes (P < 0.001). If bystanders witnessed the arrest, performed CPR, and pre-hospital defibrillation was performed, 30-day survival was 7.7% [95%CI: 3.5-11.9%] vs. 24.2% [95%CI: 22.5-25.9%] in nursing vs. private home residents.CONCLUSIONS: Average 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival.

AB - BACKGROUND: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents.METHODS: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival. Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately.RESULTS: Of 26,999 OCHAs, 2516 (9.3%) occurred in nursing homes, and 24,483 (90.7%) in private homes. Nursing home residents were older (median 83 (Q1-Q3: 75-89) vs. 71 (Q1-Q3: 61-80) years), had more witnessed arrest (55.4% vs. 43.4%), received more bystander cardiopulmonary resuscitation (CPR) (49.7% vs. 35.3%), but less pre-hospital defibrillation (15.1% vs. 29.8%). Registered AEDs increased in the period 2007-2014 from 1 to 211 in nursing homes vs. 1 to 488 in private homes. Average 30-day survival in nursing homes was 1.7% [95%CI: 1.2-2.2%] vs. 4.9% [95%CI: 4.6-5.2%] in private homes (P < 0.001). If bystanders witnessed the arrest, performed CPR, and pre-hospital defibrillation was performed, 30-day survival was 7.7% [95%CI: 3.5-11.9%] vs. 24.2% [95%CI: 22.5-25.9%] in nursing vs. private home residents.CONCLUSIONS: Average 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival.

KW - Defibrillation

KW - Nursing home

KW - Out-of-hospital cardiac arrest

KW - Resuscitation

KW - Survival

KW - Nursing Homes/statistics & numerical data

KW - Cross-Sectional Studies

KW - Time-to-Treatment

KW - Comorbidity

KW - Humans

KW - Middle Aged

KW - Homes for the Aged/statistics & numerical data

KW - Male

KW - Cardiopulmonary Resuscitation/statistics & numerical data

KW - Emergency Medical Services/statistics & numerical data

KW - Aged, 80 and over

KW - Denmark

KW - Female

KW - Registries

KW - Aged

KW - Defibrillators/statistics & numerical data

KW - Population Surveillance

KW - Out-of-Hospital Cardiac Arrest/mortality

U2 - 10.1016/j.resuscitation.2018.02.004

DO - 10.1016/j.resuscitation.2018.02.004

M3 - Journal article

C2 - 29425977

AN - SCOPUS:85041745661

SN - 0300-9572

VL - 125

SP - 90

EP - 98

JO - Resuscitation

JF - Resuscitation

ER -

Survival after out-of-hospital cardiac arrest in nursing homes – A nationwide study

Abstract

Finansiering

Dokumenter og links

SDU link

Fingeraftryk

Citationsformater