Abstract 409: Burden of Overdose in Young Adult Cardiac Arrest Cases

Abstract

Introduction: Overdose related out-of-hospital cardiac arrests (OHCA) are preventable devastating occurrences, often affecting young adults, leading to many years of productive life lost. The purpose of this study was to characterize overdose related OHCA over time and assess its excess burden in young adult cases in the state of Illinois. Methods: The Cardiac Arrest Registry to Enhance Survival (CARES) database was used. We excluded pediatric and trauma cases. Bivariate associations were assessed. Population attributable fractions (PAF) were also calculated. Results: During 2018 to 2022, a total of 23,637 non-traumatic adult OHCA cases were reported to CARES from Illinois (with a population catchment >40% in 2022). Of these, 8.2% (N=1,928) were overdose related. Overdose accounts for 9.5% of the OHCA in males, and 5.9% in females. By race and ethnicity, 9.6% of cases in Hispanics, 9.3% in Blacks and 7.3% in Whites are due to overdose. The number of overdose related OHCA peaked in 2020 (n=449); however, 2022 (n=432) contributed to the historically highest proportion of overdose related OHCA (8.5%). While the overall mean age for OHCA was 63.7 (SD=17) years with a peak at 60 years, the mean age for overdose cases was 44.7 (SD=13.5) with a peak at 50 years. While young adults (18-34-year-olds) have a lower likelihood of cardiac arrests accounting for only 6% of the total OHCA, they contribute 26% of the overdose OHCA. Young adult OHCA cases are nearly six times more likely to be overdose related (Relative Risk=5.5; 95% CI: 5.0 - 6.0) as compared to older cases. In terms of population impact, 21% of the overdose related OHCA are attributed to young adult cases (PAF=0.212). If young adults had the same risk of overdose-related OHCA as older cases, we would expect 408 fewer overdose-related OHCA, and the rate of overdose-related OHCA would drop from 8.2% to 6.4%. Similarly, for adults <40 years of age, 31% of the overdose related cardiac arrests are attributed to these young cases (PAF=0.309), and we would expect 596 fewer cases had the risk of overdose related OHCA been same as older cases. Conclusion: Overdose related OHCAs represent a significant burden in younger patients. Prevention strategies that reduce the burden of overdose related OHCA should be a public health priority.