Department of Emergency Medicine, University of California, San Francisco, USA.
Department of Emergency Medicine, University of California, San Francisco, USA.
Resuscitation. 2024 May;198:110159. doi: 10.1016/j.resuscitation.2024.110159. Epub 2024 Mar 6.
Estimates of the prevalence of drug-related out of hospital cardiac arrest (OHCA) vary, ranging from 1.8% to 10.0% of medical OHCA. However, studies conducted prior to the recent wave of fentanyl deaths likely underestimate the current prevalence of drug-related OHCA. We evaluated recent trends in drug-related OHCA, hypothesizing that the proportion of presumed drug-related OHCA treated by emergency medical services (EMS) has increased since 2015.
We conducted a retrospective analysis of OHCA patients treated by EMS providers in San Francisco, California between 2015 and 2023. Participants included OHCA cases in which resuscitation was attempted by EMS. The study exposure was the year of arrest. Our primary outcome was the occurrence of drug-related OHCA, defined as the EMS impression of OHCA caused by a presumed or known overdose of medication(s) or drug(s).
From 2015 to 2023, 5044 OHCA resuscitations attended by EMS (average 561 per year) met inclusion criteria. The median age was 65 (IQR 50-79); 3508 (69.6%) were male. The EMS impression of arrest etiology was drug-related in 446/5044 (8.8%) of OHCA. The prevalence of presumed drug-related OHCA increased significantly each year from 1% in 2015 to 17.6% in 2023 (p-value for trend = 0.0001). After adjustment, presumed drug-related OHCA increased by 30% each year from 2015-2023.
Drug-related OHCA is an increasingly common etiology of OHCA. In 2023, one in six OHCA was presumed to be drug related. Among participants less than 60 years old, one in three OHCA was presumed to be drug related.
药物相关性院外心脏骤停（OHCA）的患病率估计值差异很大，范围从 1.8%到 10.0%的医疗 OHCA。然而，在最近一波芬太尼死亡之前进行的研究可能低估了当前药物相关性 OHCA 的患病率。我们评估了最近药物相关性 OHCA 的趋势，假设自 2015 年以来，由紧急医疗服务（EMS）治疗的药物相关性 OHCA 的比例有所增加。
我们对加利福尼亚州旧金山的 EMS 提供者治疗的 OHCA 患者进行了回顾性分析，时间范围为 2015 年至 2023 年。参与者包括由 EMS 尝试复苏的 OHCA 病例。研究暴露是逮捕年份。我们的主要结果是药物相关性 OHCA 的发生，定义为 EMS 对 OHCA 的印象，原因是假定或已知药物过量或药物。
从 2015 年至 2023 年，有 5044 例 OHCA 复苏由 EMS 参加（平均每年 561 例），符合纳入标准。中位年龄为 65 岁（IQR 50-79）；3508 例（69.6%）为男性。EMS 对逮捕病因的印象在 5044 例 OHCA 中的 446/5044（8.8%）中与药物有关。假定的药物相关性 OHCA 的患病率每年显着增加，从 2015 年的 1%增加到 2023 年的 17.6%（趋势检验的 p 值=0.0001）。调整后，2015-2023 年间，假定的药物相关性 OHCA 每年增加 30%。
药物相关性 OHCA 是 OHCA 的一种越来越常见的病因。在 2023 年，六分之一的 OHCA 被认为与药物有关。在年龄小于 60 岁的参与者中，三分之一的 OHCA 被认为与药物有关。
