Cardiac arrest caused by acute intoxication—insight from a registry

Hörburger, David; Kürkciyan, Istepan; Sterz, Fritz; Schober, Andreas; Stöckl, Mathias; Stratil, Peter; Uray, Thomas; Testori, Christoph; Weiser, Christoph; Haugk, Moritz

doi:10.1016/j.ajem.2013.07.005

Cited by 15 publications

(9 citation statements)

References 17 publications

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“…This was surprisingly higher than we anticipated and compared to previous data (1-19 %) [4][5][6][7]. Only one prior study reported similar rates of survival with good neurological outcome of 34 % [3]. The survival data of 8.5 % in the Melbourne study and 16 % in Katz's study is significantly lower than our finding of 42 % survival.…”

Section: Discussioncontrasting

confidence: 86%

“…However, organic heart disease is the focus of these reports and there is limited published experience regarding the epidemiology of toxin-induced cardiac arrest (TICA) and resuscitation outcomes. Six prior database studies in the last 11 years from Austria [3], the USA [4][5][6][7], and Australia [8] found a prevalence of drug-induced cardiac arrest from 3-10 %. Overall survival ranged widely from 1-34 % in five of these reports and none of these studies included TH as a therapeutic modality.…”

Section: Introductionmentioning

confidence: 99%

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Outcomes in Cardiac Arrest Patients due to Toxic Exposure Treated with Therapeutic Hypothermia

et al. 2016

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The incidence and outcome of patients who undergo therapeutic hypothermia (TH) after toxin-induced cardiac arrest (TICA) is not previously described. Our study aimed to describe the incidence, epidemiologic characteristics, and outcomes of patients who experience TICA in a dedicated clinical pathway for post-cardiac arrest care between November 2007 and February 2013. All patients were treated in an evidencebased clinical pathway that included TH. Database and medical records were independently reviewed by investigators to ascertain TICA. TICA was defined as cardiac arrest (CA) directly and immediately caused by a xenobiotic exposure. All patients were enrolled at Carolinas Medical Center, an urban 874-bed teaching hospital that serves as a regional cardiac resuscitation center. All patients were adult victims of cardiac arrest who had obtained return of spontaneous circulation and were enrolled in a clinical pathway for post-cardiac arrest care that included TH. Three hundred eighty-nine patients underwent treatment following CA during the study period and 48 (12 %) were deemed TICA. Patients who suffered TICA were slightly younger, less likely to have an initial shockable rhythm, and less likely to receive bystander CPR as compared to non-toxic cases. TICA accounted for a significant proportion of patients in this study. Additional, larger studies are needed to fully elucidate the optimal role for TH in TICA.

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Section: Discussioncontrasting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Outcomes in Cardiac Arrest Patients due to Toxic Exposure Treated with Therapeutic Hypothermia

et al. 2016

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“…Only 19.2% of patients received AAM in South Korea 27. The characteristics of pOHCA can affect the outcome; unlike during cardiac cause arrest, ventricular arrhythmia is low, and rapid respiratory support is required 14 28. It can be assumed that pOHCA is related to the damage induced by the poisons that cause hypoxia in apnoea and hypercapnia; therefore, rapid CPR is needed.…”

Section: Discussionmentioning

confidence: 99%

Nationwide population-based study of poisoning-induced out-of-hospital cardiac arrest in South Korea

2022

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ObjectiveTo evaluate the characteristics of poisoning-induced out-of-hospital cardiac arrest (pOHCA) and the factors influencing survival to discharge and good neurological outcomes using a nationwide, population-based database.DesignNationwide, retrospective, population-based cohort study.Setting and participantsThis study included adult patients who had experienced pOHCA and those who had not (non-pOHCA patients) in South Korea from January 2008 to December 2018.Outcome measuresThe primary outcome was survival to discharge, and the secondary outcome was a good neurological outcome.MethodsThe basic characteristics of pOHCA and non-pOHCA patients were analysed by descriptive analysis. Logistic regression analysis was conducted for related variables, including pOHCA.ResultsA total of 173 190 patients were included, and 3582 patients (2.1%) were in the pOHCA group. Some of the pOHCA patients were young (58.2±17.8 vs 69.0±15.5, p<0.001), a few of their cardiac arrests were witnessed (12.8% vs 45.1%, p<0.001), a few were resuscitated by bystanders (8.2% vs 14.8%, p<0.001) and they had low shockable rhythm rates (1.2% vs 8.8%, p<0.001). They showed significantly lower survival to discharge and poorer neurological outcomes than non-pOHCA patients (survival to discharge, 3.7% vs 6.2%, p<0.001; good neurological outcomes, 1.3% vs 3.2%, p<0.001). There were no significant differences between pOHCA and non-pOHCA patients in terms of the adjusted ORs for survival to discharge (adjusted OR 0.608; 95% CI 0.86 to 1.27) and good neurological outcomes (adjusted OR 1.03; 95% CI 0.73 to 1.42).ConclusionThis study shows that apparent aetiology of OHCA caused by poison, did not influence survival to discharge and good neurological outcomes. Furthermore, pOHCA occurs in younger patients and has fewer witnesses and shockable rhythms. pOHCA did not influence survival to discharge and good neurological outcomes. Also, pesticides and gases were the most frequent substances causing pOHCA in South Korea.

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“…While no known research has been done on the association between cardiac arrest and opioid overdose in transport, this result does reflect other research that found an association between cardiac arrest and opioid use during in-hospital care. 14 , 17 Most recently, Sakhuja et al 14 found that cardiac arrest was much more common in patients with opioid overdoses and that opioid overdoses were independent risk factors for cardiac arrest. This study reflected the findings of Hörburger et al 17 who found that, within his emergency department, opiates were the leading cause of intoxication-related death.…”

Section: Discussionmentioning

confidence: 99%

Association of Cardiac Arrest With Opioid Overdose in Transport

2022

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Introduction: Drug overdose is the leading cause of injury-related death in the United States. It has been linked to respiratory depression and cardiac toxicity, both of which can lead to cardiac arrest. Despite this potential association, few studies have examined this relationship, particularly in transport to the hospital. The purpose of this research was to determine if there was a relationship between opioid overdose and cardiac arrest in transport. Methods: A sample (n = 1 000 000) was utilized from the National EMS Information System (NEMSIS) from the year 2019. A logistic regression model was used to predict cardiac arrest from dispatch reason with gender, race, and age included as controls. Results: Overdose-related dispatch reason was associated with an increased likelihood of cardiac arrest in transport (Odds Ratio = 1.65, 95% Confidence Interval: [1.22, 2.22]). Conclusions: Opioid overdose is associated with an increased incidence of cardiac arrest in transport in the United States.

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Cardiac arrest caused by acute intoxication—insight from a registry

Cited by 15 publications

References 17 publications

Outcomes in Cardiac Arrest Patients due to Toxic Exposure Treated with Therapeutic Hypothermia

Outcomes in Cardiac Arrest Patients due to Toxic Exposure Treated with Therapeutic Hypothermia

Nationwide population-based study of poisoning-induced out-of-hospital cardiac arrest in South Korea

Association of Cardiac Arrest With Opioid Overdose in Transport

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