Hospital admissions and pharmacotherapy before out-of-hospital cardiac arrest according to age

Abstract

Background: The underlying etiology of sudden cardiac death varies with age and is likely to be reflected in type and number of healthcare contacts. We aimed to determine the specific type of healthcare contact shortly before out-of-hospital cardiac arrest (OHCA) across ages.

Methods: OHCA patients were identified in the nationwide Danish Cardiac Arrest Register and Copenhagen Medical Emergency Care Unit (2001-2006). We matched every OHCA patients with 10 controls on sex and age. Healthcare contacts were evaluated 30 days before event by individual-level-linkage of nationwide registers.

Results: We identified 16,924 OHCA patients, median age 70.0 years (Q1-Q3: 59-80). OHCA patients had a higher number of hospitalizations and received more pharmacotherapy compared to the control population across all ages (p for difference <0.001). OHCA patients aged 70-79 and 80-89 years had the highest proportion of hospitalizations (70%) and pharmacotherapy (73%), respectively. In general, the association between OHCA and hospitalizations and pharmacotherapy was more pronounced among the youngest OHCA patients compared to controls. OHCA patients in age groups 14-19, 20-29, 30-39 were ~5 times more likely to be in contact with the healthcare service than the control population (p for difference <0.001). Similarly, OHCA patients in the oldest age groups (60-69, 70-79, 80-89, >89) were <2 times more likely to be in contact with the healthcare services shortly before OHCA compared to the control population (p for difference <0.001).

Conclusion: Young OHCA patients are more likely to be in contact with the healthcare services compared with an age and sex matched control population suggestive of traits that make them stand out from the general population.