• Resuscitation · Apr 2024

    Prodromal complaints and 30-day survival after emergency medical services-witnessed out-of-hospital cardiac arrest.

    • LarsenMia BangMBDepartment of Clinical Medicine, Aalborg University, Denmark. Electronic address: miabanglarsen@icloud.com., Emil Blom-Hanssen, Filip Gnesin, Kristian Hay Kragholm, Lass KlitgaardThomasTDepartment of Anaesthesia and Intensive Care, Aalborg University Hospital, Denmark., ChristensenHelle CollatzHCDet Præhospitale Center, Region Sjælland, Denmark., Freddy Lippert, Fredrik Folke, Christian Torp-Pedersen, and RinggrenKristian BundgaardKBDepartment of Anesthesia and Intensive Care, North Denmark Regional Hospital, Denmark..
    • Department of Clinical Medicine, Aalborg University, Denmark. Electronic address: miabanglarsen@icloud.com.
    • Resuscitation. 2024 Apr 1; 197: 110155110155.

    BackgroundOut-of-hospital cardiac arrest (OHCA) is a frequent and lethal condition with a yearly incidence of approximately 5000 in Denmark. Thirty-day survival is associated with the patient's prodromal complaints prior to cardiac arrest. This paper examines the odds of 30-day survival dependent on the reported prodromal complaints among OHCAs witnessed by the emergency medical services (EMS).MethodsEMS-witnessed OHCAs in the Capital Region of Denmark from 2016-2018 were included. Calls to the emergency number 1-1-2 and the medical helpline for out-of-hours were analyzed according to the Danish Index; data regarding the OHCA was collected from the Danish Cardiac Arrest Registry. We performed multiple logistic regression to calculate the odds ratio (OR) of 30-day survival with adjustment for sex and age.ResultsWe identified 311 eligible OHCAs of which 79 (25.4%) survived. The most commonly reported complaints were dyspnea (n = 209, OR 0.79 [95% CI 0.46: 1.36]) and 'feeling generally unwell' (n = 185, OR 1.07 [95% CI 0.63: 1.81]). Chest pain (OR 9.16 [95% CI 5.09:16.9]) and heart palpitations (OR 3.15 [95% CI 1.07:9.46]) had the highest ORs, indicating favorable odds for 30-day survival, while unresponsiveness (OR 0.22 [95% CI 0.11:0.43]) and blue skin or lips (OR 0.30, 95% CI 0.09, 0.81) had the lowest, indicating lesser odds of 30-day survival.ConclusionExperiencing chest pain or heart palpitations prior to EMS-witnessed OHCA was associated with higher 30-day survival. Conversely, complaints of unresponsiveness or having blue skin or lips implied reduced odds of 30-day survival.Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.

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