Contacts to the healthcare system prior to out-of-hospital cardiac arrests
ON DEMAND
Speaker:
Session title: Ventricular Arrhythmias and Sudden Cardiac Death (SCD) ePosters
Topic: Ventricular Arrhythmias and SCD - Prevention
Session type: ePosters
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Authors

N Zylyftari1 , SG Moller1 , M Wissenberg1 , F Folke2 , CA Barcella1 , AL Moller3 , EHA Mills4 , HL Tan5 , L Kober6 , F Lippert2 , GH Gislason7 , CT Pedersen8 , 1Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte - Hellerup - Denmark , 2Emergency Medical Services and University of Copenhagen - Copenhagen - Denmark , 3Department of Research, Nordsjaellands Hospital - Hillerod - Denmark , 4Aalborg University Hospital, Department of Cardiology - Aalborg - Denmark , 5Department of Cardiology, Academic Medical Center, University of Amsterdam - Amsterdam - Netherlands (The) , 6Rigshospitalet - Copenhagen University Hospital, The Heart Center - Copenhagen - Denmark , 7The Danish Heart Foundation - Copenhagen - Denmark , 8Department of Clinical Investigation and Cardiology, Nordsjaellands Hospital - Hillerod - Denmark ,

Abstract

Citation: N/A

Background:

Patients who suffer a sudden out-of-hospital cardiac arrest (OHCA) may be preceded by warning symptoms and healthcare system contact. Though, is currently difficult early identification of sudden cardiac arrest patients. 

Purpose:

We aimed to examine contacts with the healthcare system up to two weeks and one year before OHCA. 

Methods:

OHCA patients were identified from the Danish Cardiac Arrest Registry (2001-2014). The pattern of healthcare contacts (with either general practitioner (GP) or hospital) within the year prior to OHCA of OHCA patients was compared with that of 9 sex- and age-matched controls from the background general population. Additionally, we evaluated characteristics of OHCA patients according to the type of healthcare contact (GP/hospital/both/no-contact) and the including characteristics of contacts, within two weeks prior their OHCA event.

Results:

Out of 28,955 OHCA patients (median age of 72 (62-81) years and with 67% male) of presumed cardiac cause, 16,735 (57.8%) contacted the healthcare system (GP and hospital) within two weeks prior to OHCA. From one year before OHCA, the weekly  percentages of contacts to GP were relatively constant (26%) until within 2 weeks prior to OHCA where they markedly increased (54%). In comparison, 14% of the general population contacted the GP during the same period (Figure). The weekly percentages of contacts with hospitals gradually increased in OHCA patients from 3.5% to 6.5% within 6 months, peaking at the second week (6.8%), prior to OHCA. In comparison, only 2% of the general population had a hospital contact in that period (Figure). Within 2 weeks of OHCA, patients contacted GP mainly by telephone (71.6%). Hospital diagnoses were heterogenous, where ischemic heart disease (8%) and heart failure (4.5%) were the most frequent. 

Conclusions:

There is an increase in healthcare contacts prior to "sudden" OHCA and overall, 54% of OHCA-patients had contacted GP within 2 weeks before the event. This could have implications for developing future strategies for early identification of patients prior to their cardiac arrest.

Legend figure: 

Figure. The weekly percentages of contacts to GP(red) and hospital(blue) within one year before OHCA comparing the OHCA cases to the age- and sex-matched control population (N cases=28.955; N controls=260.595).