British Columbia Resuscitation Research Collaborative, British Columbia, Canada; Faculty of Medicine, University of British Columbia, British Columbia, Canada.
British Columbia Resuscitation Research Collaborative, British Columbia, Canada.
Resuscitation. 2024 Feb;195:110107. doi: 10.1016/j.resuscitation.2023.110107. Epub 2023 Dec 30.
Multiple jurisdictions reported a significant increase in out-of-hospital cardiac arrest (OHCA) incidence over the past decade, however the reasons for this remain unclear. We investigated how drug-associated OHCA (DA-OHCA) contributed to overall OHCA incidence, and whether the likelihood of treatment by emergency medical services (EMS) was associated with DA-OHCA classification.
Using a large provincial cardiac arrest registry, we included consecutive, non-traumatic adult OHCA from 2016-2022. We classified as drug-associated if there were historical accounts of non-prescription drug use within the preceding 24 hours or evidence of paraphernalia at the scene. We examined year-by-year trends in OHCA and DA-OHCA incidence. We also investigated the association between DA-OHCA and odds of EMS treatment using an adjusted logistic regression model.
Of 33,365 EMS-assessed cases, 1,985/18,591 (11%) of EMS-treated OHCA and 887/9,200 (9.6%) of EMS-untreated OHCA were DA-OHCA. Of EMS-treated DA-OHCA, the median age was 40 years (IQR 31-51), 1,059 (53%) had a known history of non-prescription drug use, and 570 (29%) were public-location. From 2016 to 2022, EMS-treated OHCA incidence increased from 60 to 79 per 100,000 person-years; EMS-treated DA-OHCA incidence increased from 3.7 to 9.1 per 100,000 person-years. The proportion of overall OHCA classified as DA-OHCA increased from 6.1% to 11.5%. DA-OHCA was associated with greater odds of EMS treatment (AOR 1.34; 95%CI 1.13-1.58).
Although EMS-treated DA-OHCA incidence increased by nearly three-fold, it comprised a minority of the overall OHCA increase during the study period. DA-OHCA was associated with an increased likelihood of EMS treatment.
过去十年，多个司法管辖区报告院外心脏骤停 (OHCA) 发病率显著上升，但原因尚不清楚。我们研究了与药物相关的 OHCA (DA-OHCA) 对总体 OHCA 发病率的贡献，以及急救医疗服务 (EMS) 治疗的可能性是否与 DA-OHCA 分类相关。
使用大型省级心脏骤停登记处，我们纳入了 2016 年至 2022 年连续的非创伤性成年 OHCA。如果在过去 24 小时内有非处方药物使用的病史或在现场有用具的证据，则将其归类为与药物相关。我们检查了 OHCA 和 DA-OHCA 发病率的逐年趋势。我们还使用调整后的逻辑回归模型研究了 DA-OHCA 与 EMS 治疗几率之间的关联。
在 33365 例经 EMS 评估的病例中，1985/18591 (11%) 的 EMS 治疗 OHCA 和 887/9200 (9.6%) 的 EMS 未治疗 OHCA 为 DA-OHCA。在 EMS 治疗的 DA-OHCA 中，中位数年龄为 40 岁（IQR 31-51），1059 人（53%）有非处方药物使用的已知病史，570 人（29%）为公共场所。从 2016 年到 2022 年，EMS 治疗的 OHCA 发病率从 60 人/100,000 人年增加到 79 人/100,000 人年；EMS 治疗的 DA-OHCA 发病率从 3.7 人/100,000 人年增加到 9.1 人/100,000 人年。总体 OHCA 中被归类为 DA-OHCA 的比例从 6.1%增加到 11.5%。DA-OHCA 与 EMS 治疗几率增加相关（AOR 1.34；95%CI 1.13-1.58）。
尽管 EMS 治疗的 DA-OHCA 发病率增加了近三倍，但在研究期间仅占总体 OHCA 增加的一小部分。DA-OHCA 与 EMS 治疗的几率增加相关。
