Acute cardiac care & resuscitationCase-control study
Outcomes of out-of-hospital cardiac arrest in adult congenital heart disease: a Danish nationwide study
- Nationwide registry-based nested case-control study
- time-dependent Cox regression
- nested case-control design
Authors' conclusion
A higher risk of OHCA was found throughout the spectrum of CHD. Patients with and without CHD showed the same 30-day survival, which relies on the pre-hospital chain of survival, namely cardiopulmonary resuscitation and defibrillation.
Study context
- Population
- Danish population; OHCA of presumed cardiac cause, 2001–1943,967 cases · 219,772 controls
- Comparison
- Simple, moderate and severe congenital heart disease (CHD) vs background population
- Simple CHDn = 105
- Moderate CHDn = 144
- Severe CHDn = 53
- Outcome
- OHCA of presumed cardiac cause
Main finding
As reported in the abstract
OHCA
Each group vs no CHDHazard ratio (95% CI)
Simple CHD
1.37(1.08–1.70)
Moderate CHD
1.64(1.36–1.99)
Severe CHD
4.36(3.01–6.30)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| 30-day survival after OHCA · 30 days — Simple CHD vs No CHD | 0.95 (0.53–1.69) | |
| 30-day survival after OHCA · 30 days — Moderate CHD vs No CHD | 0.70 (0.43–1.14) | |
| 30-day survival after OHCA · 30 days — Severe CHD vs No CHD | 0.68 (0.33–1.57) | |
| 0.20.5125Odds ratio (log scale) |
30-day survival after OHCA
- Similar likelihood of 30-day survival vs no CHD
Pre-hospital CPR and defibrillation and 30-day survival in CHD
- Both associated with improved 30-day survival in CHD, regardless of severity
Original publication
Outcomes of out-of-hospital cardiac arrest in adult congenital heart disease: a Danish nationwide study. Eur Heart J. Published 6 July 2023. doi:10.1093/eurheartj/ehad358
Summarised from the published abstract; every number is checked against it