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Original research
Sudden cardiac arrest in patients with cancer in the general population: insights from the Paris-SDEC registry
  1. Orianne Weizman1,
  2. Assié Eslami2,
  3. Wulfran Bougouin1,3,
  4. Frankie Beganton1,
  5. Lionel Lamhaut1,
  6. Daniel Jost4,
  7. Florence Dumas1,
  8. Alain Cariou1,5,
  9. Eloi Marijon1,
  10. Xavier Jouven1,
  11. Mariana Mirabel1,6
  1. 1INSERM, Paris, Île-de-France, France
  2. 2Assistance Publique - Hopitaux de Paris, Paris, Île-de-France, France
  3. 3Medical Intensive Care Unit, Ramsay Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France
  4. 4Emergency Department, Paris Fire Brigade, Paris, Île-de-France, France
  5. 5Université Paris Cité - Faculté de Santé, Paris, France
  6. 6Institut Mutualiste Montsouris, Paris, France
  1. Correspondence to Dr Mariana Mirabel, Institut Mutualiste Montsouris, Paris 75014, France; mariana.mirabel{at}imm.fr

Abstract

Background Data on the management of patients with cancer presenting with sudden cardiac arrest (SCA) are scarce. We aimed to assess the characteristics and outcomes of SCA according to cancer history.

Methods Prospective, population-based registry including every out-of-hospital SCA in adults in Paris and its suburbs, between 2011 and 2019, with a specific focus on patients with cancer.

Results Out of 4069 patients who had SCA admitted alive in hospital, 207 (5.1%) had current or past medical history of cancer. Patients with cancer were older (69.2 vs 59.3 years old, p<0.001), more often women (37.2% vs 28.0%, p=0.006) with more frequent underlying cardiovascular disease (41.1% vs 32.5%, p=0.01). SCA happened more often with a non-shockable rhythm (62.6% vs 43.1%, p<0.001) with no significant difference regarding witness presence and cardiopulmonary resuscitation (CPR) performed. Cardiac causes were less frequent among patients with cancer (mostly acute coronary syndromes, 25.5% vs 46.8%, p<0.001) and had more respiratory causes (pulmonary embolism and hypoxaemia in 34.2% vs 10.8%, p<0.001). Still, no difference regarding in-hospital survival was found after SCA in patients with cancer versus other patients (26.2% vs 29.8%, respectively, p=0.27). Public location, CPR by witness and shockable rhythm were independent predictors of in-hospital survival after SCA in the cancer group.

Conclusions One in 20 SCA occurs in patients with a history of cancer, yet with fewer cardiac causes than in patients who are cancer-free. Still, in-hospital outcomes remain similar even in patients with known cancer. Cancer history should therefore not compromise the initiation of resuscitation in the context of SCA.

  • Epidemiology
  • Ventricular Fibrillation

Data availability statement

No data are available. The registry is an ongoing regional registry. Therefore updated data cannot be shared as such.

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Data availability statement

No data are available. The registry is an ongoing regional registry. Therefore updated data cannot be shared as such.

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Footnotes

  • Contributors OW wrote the paper and conducted the statistical analysis. AE gathered specific oncologic information. WB, FB, LL, DJ, FD, AC, EM and XJ designed the registry. MM planned and designed the paper. MM and EM reviewed the paper and participated in writing and interpretation of the data. MM is guarantor for the content of this paper.

  • Funding The Paris-SDEC activities are globally supported by non-profit organisations such as the Institut National de la Santé et de la Recherche Médicale (INSERM), University of Paris-Cité, Assistance Publique-Hôpitaux de Paris, Fondation Coeur et Artères, Global Heart Watch, Fédération Française de Cardiologie, Société Française de Cardiologie, Fondation Recherche Medicale. We received specific funding from Zoll for this project with however no interference in the scientific project.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.