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Chronic Health Conditions and Survival following Out-of-Hospital Ventricular Fibrillation Cardiac Arrest
  1. Heather T Carew (hcarew{at}u.washington.edu)
  1. University of Washington, United States
    1. Weiya Zhang (weiyaz{at}u.washington.edu)
    1. University of Washington, United States
      1. Thomas D Rea (rea123{at}u.washington.edu)
      1. University of Washington, United States

        Abstract

        Objective To investigate whether chronic clinical comorbidity as collected from emergency medical services (EMS) reports influences survival following out-of-hospital ventricular fibrillation (VF) cardiac arrest.

        Design Observational retrospective cohort study.

        Setting King County, Washington.

        Patients 1043 persons who suffered out-of-hospital VF arrest due to heart disease between January 1, 1999 and December 31, 2003.

        Measures Chronic conditions were ascertained and tallied from EMS reports using a uniform abstraction form by persons blinded to outcome status. The outcome was survival to hospital discharge.

        Results Seventy-five percent (776/1043) of patients had at least at least one chronic health condition and 51% (529/1043) had prior clinically-recognized heart disease. Overall, increasing count of chronic conditions was inversely associated with the odds of survival to hospital discharge after adjustment for potential confounders (odds ratio [OR] = 0.84 [0.74,0.95] for each additional chronic condition). <BR> The chronic condition-outcome association tended to be more prominent among those with longer EMS response intervals (p = 0.07 for interaction term between condition count and EMS response interval). For example, the OR of survival was 0.72 (0.59,0.88) for each additional chronic condition when the EMS response interval was 8 minutes compared to OR of 0.95 (0.79,1.14) when EMS response interval was 3 minutes.

        Conclusion In this cohort, an increasing burden of clinical comorbidity based on review of the EMS report was associated with a lower odds of survival following VF arrest. The findings suggest that chronic conditions influence the arrest pathophysiology and in turn could help guide resuscitation care.

        • cardiac arrest
        • chronic condition
        • emergency medical services
        • heart arrest
        • ventricular fibrillation

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