• 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, and Kristian Kragholm.
• Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark; Department of Anesthesiology and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark. Electronic address: marianne.pape@rn.dk.
• Resuscitation. 2018 Apr 1; 125: 90-98.

BackgroundSurvival 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.MethodsThis 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.ResultsOf 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.ConclusionsAverage 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival.Copyright © 2018 Elsevier B.V. All rights reserved.

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