• Resuscitation · Oct 2019

    Multicenter Study

    Out-of-hospital cardiac arrest in patients with psychiatric disorders - Characteristics and outcomes.

    • Carlo Alberto Barcella, Grimur H Mohr, Kristian Kragholm, Paul Blanche, Thomas A Gerds, Mads Wissenberg, Steen M Hansen, Kristian Bundgaard, Freddy K Lippert, Fredrik Folke, Christian Torp-Pedersen, Lars V Kessing, Gunnar H Gislason, and Kathrine B Søndergaard.
    • Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark. Electronic address: carlo.alberto.barcella@regionh.dk.
    • Resuscitation. 2019 Oct 1; 143: 180-188.

    AimsTo investigate whether the recent improvements in pre-hospital cardiac arrest-management and survival following out-of-hospital cardiac arrest (OHCA) also apply to OHCA patients with psychiatric disorders.MethodsWe identified all adult Danish patients with OHCA of presumed cardiac cause, 2001-2015. Psychiatric disorders were defined by hospital diagnoses up to 10 years before OHCA and analyzed as one group as well as divided into five subgroups (schizophrenia-spectrum disorders, bipolar disorder, depression, substance-induced mental disorders, other psychiatric disorders). Association between psychiatric disorders and pre-hospital OHCA-characteristics and 30-day survival were assessed by multiple logistic regression.ResultsOf 27,523 OHCA-patients, 4772 (17.3%) had a psychiatric diagnosis. Patients with psychiatric disorders had lower odds of 30-day survival (0.37 95% confidence interval 0.32-0.43) compared with other OHCA-patients. Likewise, they had lower odds of witnessed status (0.75 CI 0.70-0.80), bystander cardiopulmonary resuscitation (CPR) (0.77 CI 0.72-0.83), shockable heart rhythm (0.37 95% CI, 0.33-0.40), and return of spontaneous circulation (ROSC) at hospital arrival (0.66 CI 0.59-0.72). Similar results were seen in all five psychiatric subgroups. The difference in 30-day survival between patients with and without psychiatric disorders increased in recent years: from 8.4% (CI 7.0-10.0%) in 2006 to 13.9% (CI 12.4-15.4%) in 2015 and from 7.0% (4.3-10.8%) in 2006 to 7.0% (CI 4.5-9.7%) in 2015, respectively.ConclusionPatients with psychiatric disorders have lower survival following OHCA compared to non-psychiatric patients and the gap between the two groups has widened over time.Copyright © 2019. Published by Elsevier B.V.

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