Abstract 17263: Healthcare Contacts Before Sudden Out-of-Hospital Cardiac Arrest Can Help Identify Young Patients at Risk of Sudden Cardiac Death

Abstract

Background The underlying etiology of sudden cardiac death varies with age and is likely to be reflected in type and number of healthcare contacts. We aimed to determine the specific type of healthcare contact shortly before out-of-hospital cardiac arrest (OHCA) across ages. Methods Patients with OHCA were identified in the nationwide Danish Cardiac Arrest Register and Copenhagen Medical Emergency Care Unit from 2001-2006. We matched every OHCA patients with 10 controls on sex and age. Healthcare contacts were evaluated 30 days before event by individual-level-linkage of nationwide registers. Healthcare contact associations to OHCA were evaluated using conditional multivariate logistic regression. Results We identified 16,924 OHCA patients, median age was 70.0 years (IQR: 59-80) and 65.8% were male. In general, the association between OHCA and hospital admissions and pharmacotherapy was more pronounced among the youngest (14-34 years) OHCA patients 30 days before OHCA compared to older patients (≥75 years): antidepressants (OR=4.5, CI:2.7-7.5 and OR=1.1; CI:1.0-1.2), sedatives and anxiolytics (OR=11.1, CI:6.8-18.4 and OR=1.1, CI:1.0-1.2), anti-psychotic medication (OR=5.6, CI:2.9-11.7 and OR=1.5, CI:1.3-1.7), bronchial dilators (OR=3.4, CI:1.9-6.0 and OR=2.1, CI:1.9-2.3), and corticosteroids (OR=4.0, CI:1.0-16.4 and OR=1.8, CI:1.6-2.0). Furthermore, patients aged <40 years were >6 times more likely to be in contact with the healthcare services (than the control population whereas OHCA patients >60 years were only 2 times more likely to be in contact with the healthcare services shortly before OHCA compared to the control population (Figure 1). Conclusion Young OHCA patients are far more likely to be in contact with the healthcare services compared with an age and sex matched control population suggestive of traits that make them stand out from the general population and make them potentially identifiable before cardiac arrest.