• Resuscitation · Jul 2024

    The association of non-prescription drug use preceding out-of-hospital cardiac arrest and clinical outcomes.

    • Valerie Mok, Morgan Haines, Armin Nowroozpoor, Justin Yap, Callahan Brebner, Michael Asamoah-Boaheng, Jacob Hutton, Frank Scheuermeyer, Mypinder Sekhon, Jim Christenson, and Brian Grunau.
    • British Columbia Resuscitation Research Collaborative, British Columbia, Canada; Faculty of Medicine, University of British Columbia, British Columbia, Canada.
    • Resuscitation. 2024 Jul 10; 202: 110313110313.

    BackgroundClinicians may make prognostication decisions for out-of-hospital cardiac arrest (OHCA) using historical details pertaining to non-prescription drug use. However, differences in outcomes between OHCAs with evidence of non-prescription drug use, compared to other OHCAs, have not been well described.MethodsWe included emergency medical service-treated OHCA in the British Columbia Cardiac Arrest Registry (January/2019-June/2023). We classified cases as "non-prescription drug-associated cardiac arrests" (DA-OHCA) if there was evidence of non-prescription drug use preceding the OHCA, including witness accounts of use within 24 h or paraphernalia at the scene. We fit logistic regression models to investigate the association between DA-OHCA (vs. other cases) and favourable neurological outcome (Cerebral Performance Category [CPC] 1-2) and survival at hospital discharge, and return of spontaneous circulation (ROSC).ResultsOf 18,426 OHCA, 2,171 (12%) were classified as DA-OHCA. DA-OHCA tended to be younger, unwitnessed, occur during the evening or night, and present with a non-shockable rhythm, compared to other OHCA. DA-OHCA (221 [10%]) had a greater proportion (difference 1.8%; 95% CI 0.49-3.2) with favourable neurological outcomes compared to other OHCA (1,365 [8.4%]). Adjusted models did not identify an association of DA-OHCA with favourable neurological outcome (OR 1.08, 95% CI 0.87-1.33) or survival to hospital discharge (OR 1.13, 95% CI 0.93-1.38), but did demonstrate an association with ROSC (OR 1.13, 95% CI 1.004-1.27).ConclusionIn unadjusted models, DA-OHCA was associated with an improved odds of survival and favourable neurological outcomes at hospital discharge, compared to other OHCA. However, we did not detect an association in adjusted analyses.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

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