Survival after Out-of-Hospital Cardiac Arrest in Nursing Homes: A Nationwide Study

Marianne Pape; Shahzleen Rajan; Steen Møller Hansen; Rikke Nørmark Mortensen; Signe Riddersholm; Fredrik Folke; Lena Karlsson; Freddy Lippert; Lars Køber; Gunnar Gislason; Helle Søholm; Mads Wissenberg; Thomas A Gerds; Christian Torp-Pedersen; Kristian Kragholm

doi:10.1016/j.resuscitation.2018.02.004

Survival after Out-of-Hospital Cardiac Arrest in Nursing Homes: A Nationwide Study

Marianne Pape, Shahzleen Rajan, Steen Møller Hansen, Rikke Nørmark Mortensen, Signe Riddersholm, Fredrik Folke, Lena Karlsson, Freddy Lippert, Lars Køber, Gunnar Gislason, Helle Søholm, Mads Wissenberg, Thomas A Gerds, Christian Torp-Pedersen, Kristian Kragholm

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Abstract

BACKGROUND: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents.

METHODS: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival. Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately.

RESULTS: Of 26,999 OCHAs, 2,516 (9.3%) occurred in nursing homes, and 24,483 (90.7%) in private homes. Nursing home residents were older (median 83 (Q1-Q3: 75-89) vs. 71 (Q1-Q3: 61-80) years), had more witnessed arrest (55.4% vs. 43.4%), received more bystander cardiopulmonary resuscitation (CPR) (49.7% vs. 35.3%), but less pre-hospital defibrillation (15.1% vs. 29.8%). Registered AEDs increased in the period 2007-2014 from 1 to 211 in nursing homes vs. 1 to 488 in private homes. Average 30-day survival in nursing homes was 1.7% [95%CI: 1.2-2.2%] vs. 4.9% [95%CI: 4.6-5.2%] in private homes (P < 0.001). If bystanders witnessed the arrest, performed CPR, and pre-hospital defibrillation was performed, 30-day survival was 7.7% [95%CI: 3.5-11.9%] vs. 24.2% [95%CI: 22.5-25.9%] in nursing vs. private home residents.

CONCLUSIONS: Average 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival.

Original language	English
Journal	Resuscitation
Volume	125
Pages (from-to)	90-98
Number of pages	9
ISSN	0300-9572
DOIs	https://doi.org/10.1016/j.resuscitation.2018.02.004
Publication status	Published - Apr 2018

Keywords

Defibrillation
Nursing home
Out-of-hospital cardiac arrest
Resuscitation
Survival
Nursing Homes/statistics & numerical data
Cross-Sectional Studies
Time-to-Treatment
Comorbidity
Humans
Middle Aged
Homes for the Aged/statistics & numerical data
Male
Cardiopulmonary Resuscitation/statistics & numerical data
Emergency Medical Services/statistics & numerical data
Aged, 80 and over
Denmark
Female
Registries
Aged
Defibrillators/statistics & numerical data
Population Surveillance
Out-of-Hospital Cardiac Arrest/mortality

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10.1016/j.resuscitation.2018.02.004

Survival_after_Out_of_Hospital_Cardiac_Arrest_in_Nursing_Homes_A_Nationwide_StudyAccepted author manuscript, 763 KBLicence: CC BY-NC-ND 4.0

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Pape, M., Rajan, S., Hansen, S. M., Mortensen, R. N., Riddersholm, S., Folke, F., Karlsson, L., Lippert, F., Køber, L., Gislason, G., Søholm, H., Wissenberg, M., Gerds, T. A., Torp-Pedersen, C., & Kragholm, K. (2018). Survival after Out-of-Hospital Cardiac Arrest in Nursing Homes: A Nationwide Study. Resuscitation, 125, 90-98. Advance online publication. https://doi.org/10.1016/j.resuscitation.2018.02.004

@article{228fd581a6a94204ba9961c4d8611102,

title = "Survival after Out-of-Hospital Cardiac Arrest in Nursing Homes: A Nationwide Study",

abstract = "BACKGROUND: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents.METHODS: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival. Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately.RESULTS: Of 26,999 OCHAs, 2,516 (9.3%) occurred in nursing homes, and 24,483 (90.7%) in private homes. Nursing home residents were older (median 83 (Q1-Q3: 75-89) vs. 71 (Q1-Q3: 61-80) years), had more witnessed arrest (55.4% vs. 43.4%), received more bystander cardiopulmonary resuscitation (CPR) (49.7% vs. 35.3%), but less pre-hospital defibrillation (15.1% vs. 29.8%). Registered AEDs increased in the period 2007-2014 from 1 to 211 in nursing homes vs. 1 to 488 in private homes. Average 30-day survival in nursing homes was 1.7% [95%CI: 1.2-2.2%] vs. 4.9% [95%CI: 4.6-5.2%] in private homes (P < 0.001). If bystanders witnessed the arrest, performed CPR, and pre-hospital defibrillation was performed, 30-day survival was 7.7% [95%CI: 3.5-11.9%] vs. 24.2% [95%CI: 22.5-25.9%] in nursing vs. private home residents.CONCLUSIONS: Average 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival.",

keywords = "Defibrillation, Nursing home, Out-of-hospital cardiac arrest, Resuscitation, Survival, Nursing Homes/statistics & numerical data, Cross-Sectional Studies, Time-to-Treatment, Comorbidity, Humans, Middle Aged, Homes for the Aged/statistics & numerical data, Male, Cardiopulmonary Resuscitation/statistics & numerical data, Emergency Medical Services/statistics & numerical data, Aged, 80 and over, Denmark, Female, Registries, Aged, Defibrillators/statistics & numerical data, Population Surveillance, Out-of-Hospital Cardiac Arrest/mortality",

author = "Marianne Pape and Shahzleen Rajan and Hansen, {Steen M{\o}ller} and Mortensen, {Rikke N{\o}rmark} and Signe Riddersholm and Fredrik Folke and Lena Karlsson and Freddy Lippert and Lars K{\o}ber and Gunnar Gislason and Helle S{\o}holm and Mads Wissenberg and Gerds, {Thomas A} and Christian Torp-Pedersen and Kristian Kragholm",

year = "2018",

month = apr,

doi = "10.1016/j.resuscitation.2018.02.004",

language = "English",

volume = "125",

pages = "90--98",

journal = "Resuscitation",

issn = "0300-9572",

publisher = "Elsevier",

}

TY - JOUR

T1 - Survival after Out-of-Hospital Cardiac Arrest in Nursing Homes

T2 - A Nationwide Study

AU - Pape, Marianne

AU - Rajan, Shahzleen

AU - Hansen, Steen Møller

AU - Mortensen, Rikke Nørmark

AU - Riddersholm, Signe

AU - Folke, Fredrik

AU - Karlsson, Lena

AU - Lippert, Freddy

AU - Køber, Lars

AU - Gislason, Gunnar

AU - Søholm, Helle

AU - Wissenberg, Mads

AU - Gerds, Thomas A

AU - Torp-Pedersen, Christian

AU - Kragholm, Kristian

PY - 2018/4

Y1 - 2018/4

N2 - BACKGROUND: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents.METHODS: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival. Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately.RESULTS: Of 26,999 OCHAs, 2,516 (9.3%) occurred in nursing homes, and 24,483 (90.7%) in private homes. Nursing home residents were older (median 83 (Q1-Q3: 75-89) vs. 71 (Q1-Q3: 61-80) years), had more witnessed arrest (55.4% vs. 43.4%), received more bystander cardiopulmonary resuscitation (CPR) (49.7% vs. 35.3%), but less pre-hospital defibrillation (15.1% vs. 29.8%). Registered AEDs increased in the period 2007-2014 from 1 to 211 in nursing homes vs. 1 to 488 in private homes. Average 30-day survival in nursing homes was 1.7% [95%CI: 1.2-2.2%] vs. 4.9% [95%CI: 4.6-5.2%] in private homes (P < 0.001). If bystanders witnessed the arrest, performed CPR, and pre-hospital defibrillation was performed, 30-day survival was 7.7% [95%CI: 3.5-11.9%] vs. 24.2% [95%CI: 22.5-25.9%] in nursing vs. private home residents.CONCLUSIONS: Average 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival.

AB - BACKGROUND: Survival among nursing home residents who suffers out-of-hospital cardiac arrest (OHCA) is sparsely studied. Deployment of automated external defibrillators (AEDs) in nursing home facilities in Denmark is unknown. We examined 30-day survival following OHCA in nursing and private home residents.METHODS: This register-based, nationwide, follow-up study identified OHCA-patients ≥18 years of age with a resuscitation attempt in nursing homes and private homes using Danish Cardiac Arrest Register data from June 1, 2001 to December 31, 2014. The primary outcome measure was 30-day survival. Multiple logistic regression analyses were used to assess factors potentially associated with survival among nursing and private home residents separately.RESULTS: Of 26,999 OCHAs, 2,516 (9.3%) occurred in nursing homes, and 24,483 (90.7%) in private homes. Nursing home residents were older (median 83 (Q1-Q3: 75-89) vs. 71 (Q1-Q3: 61-80) years), had more witnessed arrest (55.4% vs. 43.4%), received more bystander cardiopulmonary resuscitation (CPR) (49.7% vs. 35.3%), but less pre-hospital defibrillation (15.1% vs. 29.8%). Registered AEDs increased in the period 2007-2014 from 1 to 211 in nursing homes vs. 1 to 488 in private homes. Average 30-day survival in nursing homes was 1.7% [95%CI: 1.2-2.2%] vs. 4.9% [95%CI: 4.6-5.2%] in private homes (P < 0.001). If bystanders witnessed the arrest, performed CPR, and pre-hospital defibrillation was performed, 30-day survival was 7.7% [95%CI: 3.5-11.9%] vs. 24.2% [95%CI: 22.5-25.9%] in nursing vs. private home residents.CONCLUSIONS: Average 30-day survival after OHCA was very low in nursing home residents, but those who received early resuscitative efforts had higher chance of survival.

KW - Defibrillation

KW - Nursing home

KW - Out-of-hospital cardiac arrest

KW - Resuscitation

KW - Survival

KW - Nursing Homes/statistics & numerical data

KW - Cross-Sectional Studies

KW - Time-to-Treatment

KW - Comorbidity

KW - Humans

KW - Middle Aged

KW - Homes for the Aged/statistics & numerical data

KW - Male

KW - Cardiopulmonary Resuscitation/statistics & numerical data

KW - Emergency Medical Services/statistics & numerical data

KW - Aged, 80 and over

KW - Denmark

KW - Female

KW - Registries

KW - Aged

KW - Defibrillators/statistics & numerical data

KW - Population Surveillance

KW - Out-of-Hospital Cardiac Arrest/mortality

UR - http://www.scopus.com/inward/record.url?scp=85041745661&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2018.02.004

DO - 10.1016/j.resuscitation.2018.02.004

M3 - Journal article

C2 - 29425977

SN - 0300-9572

VL - 125

SP - 90

EP - 98

JO - Resuscitation

JF - Resuscitation

ER -

Survival after Out-of-Hospital Cardiac Arrest in Nursing Homes: A Nationwide Study

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