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Out-of-hospital cardiac arrests in the young population; a 6-year review of the Irish out-of-hospital cardiac arrest register
  1. Richard Tanner1,
  2. Siobhan Masterson2,
  3. Joseph Galvin3,
  4. Peter Wright4,
  5. David Hennelly5,
  6. Andrew Murphy6,
  7. Gerard Bury7,
  8. Cathal O'Donnell5,
  9. Conor Deasy8
  1. 1Cardiology, Cork University Hospital Group, Cork, Ireland
  2. 2Discipline of General Practice, University College Galway, Galway, Galway, Ireland
  3. 3Mater Misericordiae University Hospital, Dublin, Ireland
  4. 4Public Health, University College Galway, Galway, Galway, Ireland
  5. 5National Ambulance Service, Health Service Executive, Dublin, Ireland
  6. 6Department of General practice, University College Galway, Galway, Galway, Ireland
  7. 7University College Dublin, National University of Ireland, Dublin, Ireland
  8. 8Emergency Medicine Department, Cork University Hospital Group, Cork, Ireland
  1. Correspondence to Richard Tanner, Cardiology, Cork University Hospital Group, Cork T12DC4A, Ireland; richard.tanner{at}umail.ucc.ie

Abstract

Study purpose Out-of-hospital cardiac arrests (OHCA) in the young population have only been examined in a limited number of regional studies. Hence, we sought to describe OHCA characteristics and predictors of survival to hospital discharge for the young Irish population.

Study design An observational analysis of the national Irish OHCA register for all OHCAs aged ≤35 years between January 2012 and December 2017 was performed. The young population was categorised into three age groups: ≤1 year, 1–15 years and 16–35 years. Multivariable logistic regression was used to determine the independent predictors of survival to hospital discharge.

Results A total of 1295 OHCAs aged ≤35 years (26.9% female, median age 25 (IQR 17–31)) had resuscitation attempted. OHCAs in those aged ≥16 years (n=1005) were more likely to happen outside the home (38.5% vs 22.8%, p<0.001) and be of non-medical aetiology (59% vs 27.6%, p<0.001) compared with those aged <16 years (n=290). Asphyxiation, trauma and drug overdoses accounted for over 90% of the non-medical OHCAs for those 16–35 years. Overall survival to hospital discharge for the cohort was 5.1%; survival was non-significantly higher for those aged 16–35 years compared with those aged 1–15 years (6.0%, vs 2.8% p=0.93). Independent predictors of survival to hospital discharge included bystander witnessed OHCA, a shockable initial rhythm and a bystander defibrillation attempt.

Conclusions The high prevalence of non-medical OHCAs and the OHCA location need to be considered when developing OHCA care pathways and preventative strategies to reduce the burden of OHCAs in the young population.

  • paediatric cardiology
  • epidemiology
  • cardiac epidemiology
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Footnotes

  • Contributors Coauthor contribution. RT: lead author, study design, collection on data, drafted manuscript. SM: study methodology, guided data analysis and edited final draft. JG: analysis of data, expert advice on sudden cardiac death, edited manuscript. PW contributed to study conception, reviewed paper and provided critical review. DH expert advise on national ambulance service, analysed data, approved final manuscript. AM contributed to data acquisition, critically reviewed manuscript. GB critically reviewed paper and provided editing of manuscript. CO’D contributed to data analysis, reviewed paper and approved final draft. CD: study supervisor, contributed to study design, data analysis and critically reviewed final manuscript. All coauthors have approved the final draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval for this study was granted by the Clinical Research Ethics Committee of Cork Teaching Hospital (reference ECM 4 (b) 05/03/2019). Results that yielded <5 cases per category were not reported to preserve patient anonymity in accordance with the OHCAR data sharing policy.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data was sourced from the national Out-of-Hospital Cardiac Arrest Register (OHCAR). Applications for viewing or use of original data are processed on an individual case basis and at the discretion of the Steering group. Further information is available at https://www.nuigalway.ie/ohcar/.Use of data reported in this study will be made available upon reasonable request to the corresponding author.

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