title: Pharmacotherapy and hospital admissions before out-of-hospital cardiac arrest: a nationwide study.
abstract: BACKGROUND
  For out-of-hospital cardiac arrest (OHCA) to be predicted and prevented, it is imperative the healthcare system has access to those vulnerable before the event occurs. We aimed to determine the extent of contact to the healthcare system before OHCA.
  
  
  METHODS
  All patients in Denmark with a registered OHCA June 1, 2001-December 31, 2005 were matched on age and sex with 10 random controls from the entire Danish population. We estimated the association with OHCA by conditional logistic regression analyses, and we determined the proportion of patients in contact with the healthcare system before OHCA from hospital admissions or claimed prescriptions.
  
  
  RESULTS
  We identified 12,089 patients with an OHCA. Of these, 62% (7548) and 85% (10,312) were in contact with the healthcare system up to 30 days and 1 year before OHCA, respectively. Association with OHCA up to 30 days before the event pertained to myocardial infarction (odds ratio (OR)=6.4, 95% confidence interval (CI): 4.7-8.6)); heart failure (OR=5.1, CI: 4.1-6.3); ischemic heart disease (OR=1.9, CI: 1.6-2.4); and cardiac dysrhythmia (OR=1.8, CI: 1.4-2.2). Concomitant pharmacotherapy up to 30 days before OHCA with the strongest association was: corticosteroids (systemic) (OR=2.7, CI: 2.5-3.0), bronchial dilators (OR=2.5, CI: 2.3-2.7), anti-psychotic medication (OR=2.1, CI: 1.9-2.3), and digoxin (OR=2.1, CI: 2.0-2.3). Similar results were found for associations up to 1 year before OHCA.
  
  
  CONCLUSIONS
  Contrary to general belief, the majority of OHCA patients are in contact with the healthcare system shortly before OHCA.
authors: Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark. pw@heart.dk
authors: Peter
authors: P
authors: Weeke
authors: Fredrik
authors: F
authors: Folke
authors: Gunnar H
authors: GH
authors: Gislason
authors: Freddy K
authors: FK
authors: Lippert
authors: Jonas B
authors: JB
authors: Olesen
authors: Charlotte
authors: C
authors: Andersson
authors: Emil L
authors: EL
authors: Fosbøl
authors: Mette G
authors: MG
authors: Charlot
authors: Jørgen K
authors: JK
authors: Kanters
authors: Henrik E
authors: HE
authors: Poulsen
authors: Søren Loumann
authors: SL
authors: Nielsen
authors: Lars
authors: L
authors: Køber
authors: Christian
authors: C
authors: Torp-Pedersen
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000628:therapy; D001993:Bronchodilator Agents / Q000627:therapeutic use; D003718:Denmark; D004077:Digoxin / Q000627:therapeutic use; D005260:Female; D015438:Health Behavior; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D017202:Myocardial Ischemia / Q000628:therapy; D058687:Out-of-Hospital Cardiac Arrest / Q000517:prevention & control*; D010343:Patient Admission; D012044:Regression Analysis
chemical_list: D000305:Adrenal Cortex Hormones; D014150:Antipsychotic Agents; D001993:Bronchodilator Agents; D004077:Digoxin