Contacts with the health care system before out-of-hospital cardiac arrest

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BACKGROUND: It remains challenging to identify patients at risk of out-of-hospital cardiac arrest (OHCA). We aimed to examine health care contacts in patients before OHCA compared with the general population that did not experience an OHCA. METHODS AND RESULTS: Patients with OHCA with a presumed cardiac cause were identified from the Danish Cardiac Arrest Registry (2001– 2014) and their health care contacts (general practitioner [GP]/hospital) were examined up to 1 year before OHCA. In a case-control study (1:9), OHCA contacts were compared with an age-and sex-matched background population. Separately, patients with OHCA were examined by the contact type (GP/hospital/both/no contact) within 2 weeks before OHCA. We included 28 955 patients with OHCA. The weekly percentages of patient contacts with GP the year before OHCA were constant (25%) until 1 week before OHCA when they markedly increased (42%). Weekly percentages of patient contacts with hospitals the year before OHCA gradually increased during the last 6 months (3.5%– 6.6%), peaking at the second week (6.8%) before OHCA; mostly attributable to cardiovascular diseases (21%). In comparison, there were fewer weekly contacts among controls with 13% for GP and 2% for hospital contacts (P<0.001). Within 2 weeks before OHCA, 57.8% of patients with OHCA had a health care contact, and these patients had more contacts with GP (odds ratio [OR], 3.17; 95% CI, 3.09– 3.26) and hospital (OR, 2.32; 95% CI, 2.21– 2.43) compared with controls. CONCLUSIONS: The health care contacts of patients with OHCA nearly doubled leading up to the OHCA event, with more than half of patients having health care contacts within 2 weeks before arrest. This could have implications for future preventive strategies.

OriginalsprogEngelsk
Artikelnummere021827
TidsskriftJournal of the American Heart Association
Vol/bind10
Udgave nummer23
ISSN2047-9980
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
This project has received funding from the European Union’s Horizon 2020 Research and Innovation Program European Sudden Cardiac Arrest Network Towards Prevention, Education, New Effective Treatment under grant agreement no. 733381, and the COST Action PARQ (grant agreement no. CA19137) supported by European Cooperation in Science and Technology. The sponsor of the study had no role in the study design, data collection, data analysis, data interpretation, and writing of this article.

Funding Information:
This project has received funding from the European Union?s Horizon 2020 Research and Innovation Program European Sudden Cardiac Arrest Network Towards Prevention, Education, New Effective Treatment under grant agreement no. 733381, and the COST Action PARQ (grant agreement no. CA19137) supported by European Cooperation in Science and Technology. The sponsor of the study had no role in the study design, data collection, data analysis, data interpretation, and writing of this article.

Funding Information:
Dr Zylyftari received a grant from European Union’s Horizon 2020 research and innovation program and Helsefonden. Dr Møller received a grant from Karen Elise Jensen Fonden and Helsefonden. Dr Tan reports receiving grants from European Union’s Horizont 2020 research and innovation program. Dr Køber received payment for speaking at a symposium arranged by Novartis, AstraZeneca, and Boehringer. Drs Gislason and Folke are supported by an unrestricted clinical research grant from the Novo Nordisk Foundation. Dr Torp-Pedersen reports receiving grant support and honoraria from Bayer and Novo Nordisk. The remaining authors have no disclosures to report.

Publisher Copyright:
© 2021 The Authors.

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