The impact of COVID-19 pandemic on out-of-hospital cardiac arrest: An individual patient data meta-analysis.

Autor: Baldi E; Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Cardiac Arrest and Resuscitation Science Research Team (RESTART), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Electronic address: enrico.baldi@unipv.it., Klersy C; Biostatistics & Clinical Trial Center, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Chan P; Department of Medicine, Saint Luke's Mid America Heart Institute, Kansas City, USA., Elmer J; Departments of Emergency Medicine, Critical Care Medicine and Neurology, University of Pittsburgh, Pittsburgh, USA., Ball J; Centre of Cardiovascular Research & Education in Therapeutics (CCRET), School of Public Health and Preventive Medicine, Monash University, Clayton, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia; Centre for Research and Evaluation, Ambulance Victoria, Melbourne, Australia., Counts CR; University of Washington School of Medicine, Seattle, USA; Seattle Fire Department, Seattle, USA., Rosell Ortiz F; Servicio de Emergencias 061 de La Rioja, Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, Spain., Fothergill R; Clinical Audit & Research Unit, London Ambulance Service NHS Trust, London, UK., Auricchio A; Fondazione Ticino Cuore, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana (USI), Lugano, Switzerland; Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland., Paoli A; Centrale Operativa Provinciale SUEM 118, Azienda ULSS 5 Polesana, Rovigo, Italy., Karam N; Division of Cardiology, European Georges Pompidou Hospital, Paris, France., McNally B; Emory University School of Medicine, Rollins School of Public Health, Atlanta, USA., Martin-Gill C; Departments of Emergency Medicine, Critical Care Medicine and Neurology, University of Pittsburgh, Pittsburgh, USA., Nehme Z; Centre of Cardiovascular Research & Education in Therapeutics (CCRET), School of Public Health and Preventive Medicine, Monash University, Clayton, Australia; Centre for Research and Evaluation, Ambulance Victoria, Melbourne, Australia., Drucker CJ; Public Health - Seattle & King County, Seattle, USA., Ruiz Azpiazu JI; Servicio de Emergencias 061 de La Rioja, Centro de Investigación Biomédica de La Rioja (CIBIR), Logroño, Spain., Mellett-Smith A; Clinical Audit & Research Unit, London Ambulance Service NHS Trust, London, UK., Cresta R; Fondazione Ticino Cuore, Lugano, Switzerland; Federazione Cantonale Ticinese Servizi Autoambulanze, Lugano, Switzerland., Scquizzato T; Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy., Jouven X; Division of Cardiology, European Georges Pompidou Hospital, Paris, France., Primi R; Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Cardiac Arrest and Resuscitation Science Research Team (RESTART), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., Al-Araji R; Emory University, Woodruff Health Sciences Center, Atlanta, USA., Guyette FX; Departments of Emergency Medicine, Critical Care Medicine and Neurology, University of Pittsburgh, Pittsburgh, USA., Sayre MR; University of Washington School of Medicine, Seattle, USA; Seattle Fire Department, Seattle, USA., Daponte Codina A; Andalusian School of Public Health, CIBER Epidemiology and Public Health (CIBERESP), Granada, Spain., Benvenuti C; Fondazione Ticino Cuore, Lugano, Switzerland., Marijon E; Division of Cardiology, European Georges Pompidou Hospital, Paris, France., Savastano S; Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Cardiac Arrest and Resuscitation Science Research Team (RESTART), Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Jazyk: angličtina
Zdroj: Resuscitation [Resuscitation] 2024 Jan; Vol. 194, pp. 110043. Date of Electronic Publication: 2023 Nov 10.
DOI: 10.1016/j.resuscitation.2023.110043
Abstrakt: Aim: Prior studies have reported increased out-of-hospital cardiac arrests (OHCA) incidence and lower survival during the COVID-19 pandemic. We evaluated how the COVID-19 pandemic affected OHCA incidence, bystander CPR rate and patients' outcomes, accounting for regional COVID-19 incidence and OHCA characteristics.
Methods: Individual patient data meta-analysis of studies which provided a comparison of OHCA incidence during the first pandemic wave (COVID-period) with a reference period of the previous year(s) (pre-COVID period). We computed COVID-19 incidence per 100,000 inhabitants in each of 97 regions per each week and divided it into its quartiles.
Results: We considered a total of 49,882 patients in 10 studies. OHCA incidence increased significantly compared to previous years in regions where weekly COVID-19 incidence was in the fourth quartile (>136/100,000/week), and patients in these regions had a lower odds of bystander CPR (OR 0.49, 95%CI 0.29-0.81, p = 0.005). Overall, the COVID-period was associated with an increase in medical etiology (89.2% vs 87.5%, p < 0.001) and OHCAs at home (74.7% vs 67.4%, p < 0.001), and a decrease in shockable initial rhythm (16.5% vs 20.3%, p < 0.001). The COVID-period was independently associated with pre-hospital death (OR 1.73, 95%CI 1.55-1.93, p < 0.001) and negatively associated with survival to hospital admission (OR 0.68, 95%CI 0.64-0.72, p < 0.001) and survival to discharge (OR 0.50, 95%CI 0.46-0.54, p < 0.001).
Conclusions: During the first COVID-19 pandemic wave, there was higher OHCA incidence and lower bystander CPR rate in regions with a high-burden of COVID-19. COVID-19 was also associated with a change in patient characteristics and lower survival independently of COVID-19 incidence in the region where OHCA occurred.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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