Poisoning-induced Out-of-Hospital Cardiac Arrest and Outcomes according to Poison Agent

Abstract

It is unclear whether specific agent groups are associated with outcomes in cases of poisoning-induced out-of-hospital cardiac arrest (P-OHCA). The study population comprised cases of confirmed P-OHCA drawn from the national out-of-hospital cardiac arrest (OHCA) registry (2008–2013). Exposures were categorized into five groups according to the International Classification of Disease, 10th version: group 1, prescribed drugs; group 2, vapors and gases; group 3, pesticides; group 4, alcohol and organic solvents; and group 5, other poisons. The outcome was survival to discharge and good neurological recovery. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated to test the association between specific groups and outcomes. A total of 2,083 patients were analyzed; group 1 (10.3%), group 2 (23.6%), group 3 (52.9%), group 4 (1.4%), and group 5 (13.2%). The survival to discharge and good neurological recovery rates were 3.3%/1.3% for all patients, 10.3%/5.6% (group 1), 6.9%/3.4% (group 2), 2.4%/0.4% (group 3), 2.2%/1.0% (group 4), and 3.3%/2.4% (group 5) (all P < 0.001). The aORs (95% CIs) of groups 2–5 compared with group 1 for survival to discharge were 0.47 (0.09–2.51), 0.34 (0.17–0.68), 0.33 (0.14–0.77), and 0.31 (0.13–0.77), respectively. The odds ratios (95% CIs) for good neurological recovery were significant only in group 1, the pesticides group (0.07 [0.02–0.26]) and were not significant in the other groups. P-OHCA outcomes differed significantly among the poisoning agent groups. The pesticides group showed the worst outcomes, followed by the group of vapors or gases.

Evaluation of Cardioprotective action of Suvarna gairik (Redochre) in Indian Cobra Envenomation, Aluminium Phosphide Poisoning and Doxorubicin Cardiotoxicity in Albino Rats- A Protocol

“…Before spread of poison or before absorption of poison immediate treatment at initial stage of poisoning or in snake bite will reduce duration of hospitalization and possibly mortality [15]. Poison induced Out hospital Cardiac arrest (P-OH-CA) may be prevented by prompt primary intervention [16].…”

“…Incidence of OHCAs with non-cardiac origin is 28% in an Asian countries.OHCAs can occur due to other than cardiac causes and one major non cardiac origin cause of it is poisoning. Poisoning-induced out-of-hospital cardiac arrest (P-OHCA) can be lowered by using immediate preventive measures and first aid treatment in poisoning [3].…”

Kreislaufstillstand unter besonderen Umständen

“…Ist ein Antidot verfügbar, soll dieses so früh wie möglich appliziert werden, um das Outcome zu verbessern. Es wurde gezeigt, dass das auslösende Toxin stark mit dem Outcome vergiftungsinduzierter prähospitaler Kreislaufstillstände assoziiert ist [ 288 ].…”

Survival following intentional succinylcholine injection for self-harm

“…[ 1 ] In the critically ill toxicology patient, basic resuscitative measures may increase the likelihood of survival, but in poisoned patients with out-of-hospital cardiac arrest (OHCA), survival is low (3.3%). [ 2 3 ] Sometimes, administration of an antidote could become an essential component of resuscitation. [ 4 ]…”