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. 2023 Nov 10:16:100503.
doi: 10.1016/j.resplu.2023.100503. eCollection 2023 Dec.

Characteristics, survival and neurological outcome in out-of-hospital cardiac arrest in young adults in Sweden: A nationwide study

Linnea Gustafsson  1   2 , Araz Rawshani  1   3   4 , Truls Råmunddal  1   3 , Björn Redfors  1   3 , Petur Petursson  1   3 , Oskar Angerås  1   3 , Geir Hirlekar  1   3 , Elmir Omerovic  1   3 , Christian Dworeck  1   3 , Sebastian Völz  1   3 , Johan Herlitz  4 , Clara Hjalmarsson  1   3 , Lina Dahlén Holmqvist  1   2 , Anna Myredal  1   3
Affiliations

Characteristics, survival and neurological outcome in out-of-hospital cardiac arrest in young adults in Sweden: A nationwide study

Linnea Gustafsson et al. Resusc Plus. .

Abstract

Aim: The aim of this study was to present a comprehensive overview of out-of-hospital cardiac arrests (OHCA) in young adults.

Methods: The data set analyzed included all cases of OHCA from 1990 to 2020 in the age-range 16-49 years in the Swedish Registry of Cardiopulmonary Resuscitation (SRCR). OHCA between 2010 and 2020 were analyzed in more detail. Clinical characteristics, survival, neurological outcomes, and long-time trends in survival were studied. Logistic regression was used to study 30-days survival, neurological outcomes and Utstein determinants of survival.

Results: Trends were assessed in 11,180 cases. The annual increase in 30-days survival during 1990-2020 was 5.9% with no decline in neurological function among survivors. Odds ratio (OR) for heart disease as the cause was 0.55 (95% CI 0.44 to 0.67) in 2017-2020 compared to 1990-1993. Corresponding ORs for overdoses and suicide attempts were 1.61 (95% CI 1.23-2.13) and 2.06 (95% CI 1.48-2.94), respectively. Exercise related OHCA was noted in roughly 5%. OR for bystander CPR in 2017-2020 vs 1990-1993 was 3.11 (95% CI 2.57 to 3.78); in 2020 88 % received bystander CPR. EMS response time increased from 6 to 10 minutes.

Conclusion: Survival has increased 6% annually, resulting in a three-fold increase over 30 years, with stable neurological outcome. EMS response time increased with 66% but the majority now receive bystander CPR. Cardiac arrest due to overdoses and suicide attempts are increasing.

Keywords: Cardiac arrest; Cardiovascular disease; OHCA; Survival.

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Conflict of interest statement

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.

Figures

Fig. 1
Fig. 1
Trends in 30-day survival, clinical characteristics, and critical time intervals during 1990 to 2020.
Fig. 2
Fig. 2
Odds ratios for 30-day survival in relation to age-group, adjusted for sex, location, no-flow time, and initial rhythm.
Fig. 3
Fig. 3
Cerebral performance category (CPC) score among survivors of out-of-hospital cardiac arrest 2010–2020. Odds ratios (right upper panel) for exhibiting CPC 1 at discharge, adjusted for sex, location, no-flow time, and initial rhythm.
Fig. 4
Fig. 4
Odds ratios for 30-day survival among young adults experiencing an out-of-hospital cardiac arrest (OHCA) 2010–2020.
See this image and copyright information in PMC

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