Abstract 415: Underlying Liver Disease and Survival Outcomes in Out-Of-Hospital Cardiac Arrest

Abstract

Introduction: It is unclear whether underlying liver disease can affect survival outcomes of out-of-hospital cardiac arrest (OHCA) patients. This study aims to evaluate the association between underlying liver disease and survival outcomes of OHCA patients. Methods: This study was a cross-sectional study using a nationwide OHCA registry in Korea. Adult OHCA patients with presumed cardiac etiology from 2013 to 2015 were included. The main exposure was underlying liver disease which was identified from medical record review. We categorized patients into 3 groups: chronic liver disease (CLD) with cirrhosis, CLD without cirrhosis and no CLD group. The primary outcome was discharge with good neurological recovery (cerebral performance category 1 or 2) and the secondary outcome was survival to discharge. Multivariable logistic regression was performed to calculate odds ratios (OR) with 95% confidence intervals (CIs) after adjusting for potential confounders. Results: A total of 8,844 patients, 1,323 (15%) patients had CLD with cirrhosis and 361 (4.1%) patients had CLD without cirrhosis. Good neurological recovery rate was 0.6% in CLD with cirrhosis group, 8.9% in CLD without cirrhosis group and 8.7% in no CLD group (P<0.0001). Compared to no CLD group, CLD with cirrhosis group was less likely to have favorable outcomes (adjusted OR [95% CI]: 0.28 [0.13-0.62] for good neurological recovery and 0.35 [0.21-0.59] for survival to discharge). There was no significant difference in favorable outcomes between no CLD group and CLD without cirrhosis group (adjusted OR [95% CI]: 1.64 [0.92-2.92] for good neurological recovery and 1.38 [0.87-2.19] for survival to discharge). Conclusion: Underlying CLD was associated with survival outcomes of OHCA patients. CLD with cirrhosis was associated with poor neurological recovery for OHCA patients.