Regional incidence and outcome of out-of-hospital cardiac arrest associated with overdose

Resuscitation. 2016 Feb:99:13-9. doi: 10.1016/j.resuscitation.2015.11.010. Epub 2015 Nov 27.

Abstract

Background: The frequency of lethal overdose due to prescription and non-prescription drugs is increasing in North America. The aim of this study was to estimate overall and regional variation in incidence and outcomes of out-of-hospital cardiac arrest due to overdose across North America.

Methods: We conducted a retrospective cohort study using case data for the period 2006-2010 from the Resuscitation Outcomes Consortium, a clinical research network with 10 regional clinical centers in United States and Canada. Cases of out-of-hospital cardiac arrest due to drug overdose were identified through review of data derived from prehospital clinical records. We calculated incidence of out-of-hospital cardiac arrest due to overdose per 100,000 person-years and proportion of the same among all out-of-hospital cardiac arrests. We analyzed the association between overdose cardiac arrest etiology and resuscitation outcomes.

Results: Included were 56,272 cases, of which 1351 were due to overdose. Regional incidence of out-of-hospital cardiac arrest due to overdose varied between 0.5 and 2.7 per 100,000 person years (p<0.001), and proportion of the same among all treated out-of-hospital cardiac arrests ranged from 0.8% to 4.0%. Overdose cases were younger, less likely to be witnessed, and less likely to present with a shockable rhythm. Compared to non-overdose, overdose was directly associated with return of spontaneous circulation (OR: 1.55; 95% CI: 1.35-1.78) and survival (OR: 2.14; 95% CI: 1.72-2.65).

Conclusions: Overdose made up 2.4% of all out-of-hospital cardiac arrest, although incidence varied up to 5-fold across regions. Overdose cases were more likely to survive than non-overdose cases.

Keywords: Drug overdose; Epidemiology; Non-cardiac etiology.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aged
  • Canada / epidemiology
  • Cardiopulmonary Resuscitation
  • Cohort Studies
  • Drug Overdose / complications*
  • Female
  • Humans
  • Incidence
  • Male
  • Out-of-Hospital Cardiac Arrest / chemically induced*
  • Out-of-Hospital Cardiac Arrest / epidemiology*
  • Out-of-Hospital Cardiac Arrest / therapy
  • Retrospective Studies
  • Treatment Outcome
  • United States / epidemiology