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. 2023 Nov 16:16:100495.
doi: 10.1016/j.resplu.2023.100495. eCollection 2023 Dec.

Out-of-hospital cardiac arrest in residential aged care facilities is independently associated with lower survival in Perth, Australia

Milena Talikowska  1 , Stephen Ball  1   2 , David Majewski  1 , Jason Belcher  1   2 , Rudolph Brits  2 , Sheryl Gallant  1 , Lyndall Finn  1 , Judith Finn  1   2   3   4
Affiliations

Out-of-hospital cardiac arrest in residential aged care facilities is independently associated with lower survival in Perth, Australia

Milena Talikowska et al. Resusc Plus. .

Abstract

Aim: To compare out-of-hospital cardiac arrest (OHCA) characteristics and outcomes between people aged ≥ 65 years who arrested in a residential aged care facility (RACF) versus a private residence in Perth, Australia.

Methods: We undertook a retrospective cohort study of OHCA cases attended by emergency medical services (EMS) in Perth, January 2018-December 2021. OHCA patient and event characteristics and survival outcomes were compared via univariate analysis. Multivariable logistic regression was used to investigate the relationship between residency type and (i) return of spontaneous circulation (ROSC) at emergency department (ED) and (ii) 30-day survival.

Results: A total of 435 OHCA occurred in RACFs versus 3,395 in private residences. RACF patients were significantly older (median age: 86 [IQR 79, 91] vs 78 [71, 85] years; p < 0.001), more commonly female (50.1% vs 36.8%; p < 0.001), bystander-witnessed arrests (34.9% vs 21.5%; p < 0.001), received bystander cardiopulmonary resuscitation (42.1% vs 28.6%; p < 0.001), had less shockable first monitored rhythms (4.0% vs 8.1%; p = 0.002) and more frequently had a "do not resuscitate" order identified (46.0% vs 13.6%; <0.001). Among those with EMS-attempted resuscitation or with defibrillation before EMS arrival, ROSC at ED and 30-day survival were significantly lower in the RACF group (6.2% vs 18.9%; p < 0.001 and 1.9% vs 7.7%; p < 0.001). The adjusted odds of ROSC at ED (aOR: 0.22 [95%CI: 0.10, 0.46]) and 30-day survival (aOR: 0.20 [95%CI 0.05, 0.92]) were significantly lower for RACF residents.

Conclusion: RACF residency was an independent predictor of lower survival from OHCA, highlighting the importance of end-of-life planning for RACF residents.

Keywords: nursing home; out-of-hospital cardiac arrest; residential aged care; resuscitation; survival.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Jason Belcher and Rudolph Brits are employees of SJWA. Judith Finn and Stephen Ball hold adjunct research positions with SJWA. Milena Talikowska, David Majewski, Lyndall Finn Sheryl Gallant, Judith Finn and Stephen Ball are employees of the Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU) at Curtin University; PRECRU receives research funding from SJWA. There are no other conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flowchart for the selection of the study cohort.
See this image and copyright information in PMC

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