Dataset Information

Is atrial fibrillation a risk factor for in-hospital cardiac arrest?: a Swedish retrospective cohort study.

ABSTRACT:

Introduction

Atrial fibrillation (AF) is associated with increased morbidity and mortality. Recent findings suggest that AF is also associated with out-of-hospital cardiac arrest. However, whether that association can be generalised to in-hospital cardiac arrests (IHCAs) is still unknown.

Aims

To examine whether there is a stronger association with IHCA among hospitalised patients with AF compared with patients without AF.

Materials and methods

All adult patients admitted to the Karolinska University Hospital, Stockholm, Sweden during 2014-2015 were included. Data were drawn from their medical file and matched against the Swedish Registry for Cardiopulmonary Resuscitation. Patients who were documented as ever having the International Classification of Diseases, 10th revision code I48 prior to the current hospitalisation were categorised to the AF group and the remaining were categorised to the non-AF group. The primary outcome was occurrence of an IHCA.

Results

In all, 102?416 patients were included. Among these, 10% had been diagnosed with AF and <1% (n=326) suffered from an IHCA, only 42 (13%) had a VF/VT. In a multivariable model adjusting for sex, age, CharlsonComorbidity Index score and whether the patients had been admitted electively or urgently, having AF was significantly associated with IHCA (OR 1.760; 95%?CI 1.356 to 2.269; p<0.001).

Conclusions

Within this observational cohort study, patients with AF had a stronger association with IHCA than patients without AF. AF might be an independent risk factor for IHCA.

SUBMITTER: Ryden A

PROVIDER: S-EPMC6045753 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Publications

Is atrial fibrillation a risk factor for in-hospital cardiac arrest?: a Swedish retrospective cohort study.

Ryden Alexander A Engdahl Johan J Claesson Andreas A Nordberg Per P Ringh Mattias M Hollenberg Jacob J Djärv Therese T

BMJ open 20180630 6

<h4>Introduction</h4>Atrial fibrillation (AF) is associated with increased morbidity and mortality. Recent findings suggest that AF is also associated with out-of-hospital cardiac arrest. However, whether that association can be generalised to in-hospital cardiac arrests (IHCAs) is still unknown.<h4>Aims</h4>To examine whether there is a stronger association with IHCA among hospitalised patients with AF compared with patients without AF.<h4>Materials and methods</h4>All adult patients admitted t ...[more]

PMID: 29961035

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Project description:BackgroundDrug overdose causes approximately 183,000 deaths worldwide annually and 50,000 deaths in Canada and the United States combined. Drug-related deaths are concentrated among young people, leading to a substantial burden of disease and loss of potential life years. Understanding the epidemiology, patterns of care, and prognosis of drug-related prehospital emergencies may lead to improved outcomes.MethodsWe conducted a retrospective cohort study of out-of-hospital cardiac arrests with drug-related and presumed cardiac causes between 2007 and 2013 using the Toronto Regional RescuNet Epistry database. The primary outcome was survival to hospital discharge. We computed standardized case fatality rates, and odds ratios of survival to hospital discharge for cardiac arrests with drug-related versus presumed cardiac causes, adjusting for confounders using logistic regression.ResultsThe analysis involved 21,497 cardiac arrests, including 378 (1.8%) drug-related and 21,119 (98.2%) presumed cardiac. Compared with the presumed cardiac group, drug-related arrest patients were younger and less likely to receive bystander resuscitation, have initial shockable cardiac rhythms, or be transported to hospital. There were no significant differences in emergency medical service response times, return of spontaneous circulation, or survival to discharge. Standardized case fatality rates confirmed that these effects were not due to age or sex differences. Adjusting for known predictors of survival, drug-related cardiac arrest was associated with increased odds of survival to hospital discharge (OR1.44, 95%CI 1.15-1.81).InterpretationIn out-of-hospital cardiac arrest, patients with drug-related causes are less likely than those with presumed cardiac causes to receive bystander resuscitation or have an initial shockable rhythm, but are more likely to survive after accounting for predictors of survival. The demographics and outcomes among drug-related cardiac arrest patients offers unique opportunities for prehospital intervention.

Dataset Information

Is atrial fibrillation a risk factor for in-hospital cardiac arrest?: a Swedish retrospective cohort study.

Introduction

Aims

Materials and methods

Results

Conclusions

Publications

Is atrial fibrillation a risk factor for in-hospital cardiac arrest?: a Swedish retrospective cohort study.

Similar Datasets

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