Park Song Yi, Kim Sun Hyu, Choi Byungho
Department of Emergency Medicine, College of Medicine, Dong-A University Hospital, Dong-A University, Busan, Republic of Korea.
Department of Emergency Medicine, College of Medicine, Ulsan University Hospital, University of Ulsan, Ulsan, Republic of Korea.
Front Med (Lausanne). 2025 Jan 16;12:1434543. doi: 10.3389/fmed.2025.1434543. eCollection 2025.
Although the incidence of sudden cardiac death is higher in hemodialysis (HD) patients, whether out-of-hospital cardiac arrest (OHCA) survival outcomes are poorer in this group remains unclear. This study aimed to assess the impact of HD on survival outcomes among adult nontraumatic OHCA patients and to compare these outcomes between HD and non-HD groups.
This observational cohort study retrospectively analyzed data from adult nontraumatic OHCA patients in Ulsan, South Korea, from January 2017 through December 2022. Multivariable logistic regression analysis was applied to evaluate whether HD was a risk factor for survival in OHCA patients. Survival was compared between the two groups in unadjusted, balanced groups by propensity score matching (PSM) and inverse probability of the treatment weighting (IPWT).
The study included 2,489 patients (64 HD group and 2,425 non-HD group). Undergoing HD was not significantly associated with any return of spontaneous circulation (ROSC) (adjusted odds ratio [95% confidence interval], -value, 1.648 [0.934-2.907], 0.085), survival to discharge (1.544 [0.734-3.250], 0.252), or neurological outcomes (0.394 [0.017-9.346], 0.564). There were also no significant differences observed in any ROSC (1.648 [0.934-2.907], 0.085), survival to discharge (1.544 [0.734-3.250], 0.252), or favorable neurological outcome (0.394 [0.017-9.346], 0.564) between the two unadjusted groups. The insignificant survival differences were persistently observed in the PSM group and IPWT group.
Although HD may pose a risk factor for cardiac arrest, our study did not find a significant association with survival outcomes in OHCA patients. Additionally, no notable survival difference was observed between HD and non-HD groups. Therefore, resuscitation efforts in HD patients should not be underestimated.
尽管血液透析（HD）患者心源性猝死的发生率较高，但该组患者院外心脏骤停（OHCA）的生存结局是否更差仍不清楚。本研究旨在评估HD对成年非创伤性OHCA患者生存结局的影响，并比较HD组和非HD组之间的这些结局。
这项观察性队列研究回顾性分析了2017年1月至2022年12月韩国蔚山成年非创伤性OHCA患者的数据。应用多变量逻辑回归分析来评估HD是否是OHCA患者生存的危险因素。通过倾向评分匹配（PSM）和治疗权重逆概率（IPWT）在未调整的平衡组中比较两组的生存率。
该研究纳入了2489例患者（HD组64例，非HD组2425例）。接受HD与任何自主循环恢复（ROSC）（调整后的优势比[95%置信区间]，P值，1.648[0.934 - 2.907]，0.085）、出院生存率（1.544[0.734 - 3.250]，0.252）或神经学结局（0.394[0.017 - 9.346]，0.564）均无显著相关性。在两个未调整的组之间，在任何ROSC（1.648[0.934 - 2.907]，0.085）、出院生存率（1.544[0.734 - 3.250]，0.252）或良好神经学结局（0.394[0.017 - 9.346]，0.564）方面也未观察到显著差异。在PSM组和IPWT组中持续观察到生存差异不显著。
尽管HD可能是心脏骤停的一个危险因素，但我们的研究未发现其与OHCA患者的生存结局有显著关联。此外，HD组和非HD组之间未观察到明显的生存差异。因此，不应低估HD患者的复苏努力。
