Journal
RESUSCITATION
Volume 99, Issue -, Pages 13-19Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.resuscitation.2015.11.010
Keywords
Drug overdose; Epidemiology; Non-cardiac etiology
Categories
Funding
- University of Washington Data Coordinating Center [5U01 HL077863]
- University of Iowa [HL077865]
- Medical College of Wisconsin [HL077866]
- University of Washington [HL077867]
- University of Pittsburgh [HL077871]
- St. Michael's Hospital [HL077872]
- Oregon Health and Science University [HL077873]
- University of Alabama at Birmingham [HL077881]
- Ottawa Hospital Research Institute [HL077885]
- University of Texas SW Medical Ctr/Dallas [HL077887]
- University of California San Diego) from the National Heart, Lung and Blood Institute [HL077908]
- National Institute of Neurological Disorders and Stroke
- U.S. Army Medical Research & Material Command
- Canadian Institutes of Health Research (CIHR) - Institute of Circulatory and Respiratory Health, Defence Research and Development Canada
- Heart and Stroke Foundation of Canada
- American Heart Association
- Pittsburgh Emergency Medicine Foundation
- University of Washington via the Leonard A Cobb Medic One Foundation Endowed Chair in Prehospital Emergency Care
- National Heart, Lung, and Blood Institute, Bethesda, MD
- NIH [U01 HL077863-05]
- Co-PI
- Food and Drug Administration, Silver Spring, MD
- Cardiac Science Corp, Waukesha, WI
- Heartsine Technologies Inc., Newtown, PA
- Philips Healthcare Inc., Bothell, WA
- Physio-Control Inc., Redmond, WA
- ZOLL Inc., Chelmsford, MA
- Abiomed Inc.
- Danvers, MA
- NIH NHLBI grant
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Background: The frequency of lethal overdose due to prescription and non-prescription drugs is increasing in North America. The aim of this study was to estimate overall and regional variation in incidence and outcomes of out-of-hospital cardiac arrest due to overdose across North America. Methods: We conducted a retrospective cohort study using case data for the period 2006-2010 from the Resuscitation Outcomes Consortium, a clinical research network with 10 regional clinical centers in United States and Canada. Cases of out-of-hospital cardiac arrest due to drug overdose were identified through review of data derived from prehospital clinical records. We calculated incidence of out-ofhospital cardiac arrest due to overdose per 100,000 person-years and proportion of the same among all out-of-hospital cardiac arrests. We analyzed the association between overdose cardiac arrest etiology and resuscitation outcomes. Results: Included were 56,272 cases, of which 1351 were due to overdose. Regional incidence of out-ofhospital cardiac arrest due to overdose varied between 0.5 and 2.7 per 100,000 person years (p < 0.001), and proportion of the same among all treated out-of-hospital cardiac arrests ranged from 0.8% to 4.0%. Overdose cases were younger, less likely to be witnessed, and less likely to present with a shockable rhythm. Compared to non-overdose, overdose was directly associated with return of spontaneous circulation (OR: 1.55; 95% CI: 1.35-1.78) and survival (OR: 2.14; 95% CI: 1.72-2.65). Conclusions: Overdose made up 2.4% of all out-of-hospital cardiac arrest, although incidence varied up to 5-fold across regions. Overdose cases were more likely to survive than non-overdose cases. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
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