title: Epidemiology and outcomes of poisoning-induced out-of-hospital cardiac arrest.
abstract: OBJECTIVE
  We aimed to describe and compare the epidemiologic features and outcomes among patients with poisoning-induced out-of-hospital cardiac arrests (POHCAs) according to causative agent groups.
  
  
  METHODS
  We identified emergency medical service (EMS)-treated POHCA patients from a nationwide OHCA registry between 2006 and 2008, which was derived from EMS run sheets and followed by hospital record review. Utstein elements were collected and hospital outcomes (survival to admission and to discharge) were measured. We compared risk factors and outcomes according to the main poisons. Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated from a multivariate logistic regression model for hospital outcomes.
  
  
  RESULTS
  The total number of non-cardiac aetiology OHCAs was 20,536. Of these, the number of EMS-assessed and EMS-treated POHCAs was 900 (4.4%). For EMS-treated POHCAs, insecticides (n=111, 15.5%) including organophosphate and carbamates; herbicides (n=94, 13.2%); unknown pesticides (n=142, 19.9%); non-pesticide drugs (n=120, 16.8%); and unknown poisons (n=247, 6%) were identified. The survival to admission rate was 22.5% for insecticides, 3.2% for herbicides, 16.2% for unknown pesticides, 16.7% for non-pesticides and 11.3% for the unknown group. The survival to discharge rates were 9.9% for insecticides, 0.0% for herbicides, 2.1% for unknown pesticides, 3.3% for non-pesticides and 3.2% for the unknown group. The adjusted OR for each group for survival to admission was significantly lower when compared with insecticides: herbicides (OR=0.11, 95% CI=0.03-0.44), non-pesticide drugs (OR=0.28, 95% CI=0.13-0.61) and unknown group (OR=0.40, 95% CI=0.21-0.76). The adjusted OR for each group for survival to discharge was significantly lower when compared with insecticides: herbicides (OR<0.01, 95% CI<0.01 or >99.9), unknown pesticides (OR=0.23, 95% CI=0.0.06-0.87), non-pesticide drugs (OR=0.14, 95% CI=0.04-0.54) and unknown group (OR=0.30, 95% CI=0.11-0.83).
  
  
  CONCLUSIONS
  Using a nationwide OHCA registry, we found that poisonings were responsible for 4.4% of OHCAs of a non-cardiac aetiology. Ingestion of insecticides including organophosphate and carbamate was associated with more favourable outcomes.
authors.affiliation: Department of Emergency Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-Gu, Seoul 110-744, Republic of Korea. timthe@gmail.com
authors.forename: Jeong Ho
authors.initials: JH
authors.lastname: Park
authors.forename: Sang Do
authors.initials: SD
authors.lastname: Shin
authors.forename: Kyoung Jun
authors.initials: KJ
authors.lastname: Song
authors.forename: Chang Bae
authors.initials: CB
authors.lastname: Park
authors.forename: Young Sun
authors.initials: YS
authors.lastname: Ro
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Kwak
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000139:chemically induced / Q000453:epidemiology* / Q000628:therapy; D011041:Poisoning / Q000150:complications*; D011159:Population Surveillance; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends