Substantial differences in presentation and outcomes seen by drug profile
By Lori Solomon HealthDay Reporter
TUESDAY, Nov. 7, 2023 (HealthDay News) — The incidence of drug overdose-related out-of-hospital cardiac arrest (OD-OHCA) more than doubled from 2015 to 2021, according to a study published online Nov. 7 in JAMA Network Open.
Vidhushei Yogeswaran, M.D., from University of Washington in Seattle, and colleagues evaluated the temporal pattern, clinical presentation, care, and outcomes of adult patients with OHCA overall and according to the drug-specific profile. The analysis included 6,790 adult patients with emergency medical services-treated OHCA (2015 through 2021).
The researchers found that the incidence of OD-OHCA significantly increased from 5.2 per 100,000 person-years in 2015 to 13.0 per 100,000 person-years in 2021, while there was no significant temporal change in the incidence of non-OD-OHCA. OD-OHCAs were more likely to be unwitnessed (66 versus 41 percent) and less likely to be shockable (8 versus 25 percent) when compared with non-OD-OHCAs. There was no significant difference observed in unadjusted survival (20 percent for OD versus 18 percent for non-OD). Combined opioid-stimulant OHCA showed the greatest relative increase in incidence. There were differences in presentation and outcomes by drug profile (e.g., patients with stimulant-only OHCA were more likely to have a shockable rhythm versus those with opioid-only OHCA [24 versus 4 percent]).
“The combination of increasing incidence and lower survival among OHCA secondary to combined opioid-stimulant substance use frames an urgent need for prevention and resuscitation strategies in this population,” the authors write.
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