title: Temporal trends in survival after out-of-hospital cardiac arrest in patients with and without underlying chronic obstructive pulmonary disease.
abstract: Survival after out-of-hospital cardiac arrest (OHCA) has tripled during the past decade in Denmark as a likely result of improvements in cardiac arrest management. This study analyzed whether these improvements were applicable for patients with chronic obstructive pulmonary disease (COPD).
  
  
  
  Patients ≥18 years with OHCA of presumed cardiac cause were identified through the Danish Cardiac Arrest Registry, 2001-2011. Patients with a history of COPD up to ten years prior to arrest were identified from the Danish National Patient Register and compared to non-COPD patients.
  
  
  
  Of 21,480 included patients, 3056 (14.2%) had history of COPD. Compared to non-COPD patients, COPD patients were older (75 vs. 71 years), less likely male (61.2% vs. 68.5%), had higher prevalence of other comorbidities, and were less likely to have: arrests outside private homes (17.7% vs. 28.3%), witnessed arrests (48.7% vs. 52.9%), bystander cardiopulmonary resuscitation (25.8% vs. 34.8%), and shockable heart rhythm (15.6% vs. 29.9%), all p<0.001; while no significant difference in the time-interval from recognition of arrest to rhythm analysis by ambulance-crew; p=0.24. From 2001 to 2011, survival upon hospital arrival increased in both patient-groups (from 6.8% to 17.1% in COPD patients and from 8.2% to 25.6% in non-COPD patients, p<0.001). However, no significant change was observed in 30-day survival in COPD patients (from 3.7% to 2.1%, p=0.27), in contrast to non-COPD patients (from 3.5% to 13.0%, p<0.001).
  
  
  
  Despite generally improved 30-day survival after OHCA over time, no improvement was observed in 30-day survival in COPD patients.
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark. Electronic address: Sidselgm@gmail.com.
authors.forename: Sidsel G
authors.initials: SG
authors.lastname: Møller
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
authors.forename: Shahzleen
authors.initials: S
authors.lastname: Rajan
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Folke
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
authors.forename: Carolina Malta
authors.initials: CM
authors.lastname: Hansen
authors.affiliation: Department of Health, Science and Technology, Aalborg University, Denmark.
authors.forename: Steen Møller
authors.initials: SM
authors.lastname: Hansen
authors.affiliation: Cardiovascular Research Center, Department of Anesthesiology, Aalborg University Hospital, Denmark.
authors.forename: Kristian
authors.initials: K
authors.lastname: Kragholm
authors.affiliation: Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark.
authors.forename: Freddy K
authors.initials: FK
authors.lastname: Lippert
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark.
authors.forename: Lena
authors.initials: L
authors.lastname: Karlsson
authors.affiliation: The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.affiliation: Department of Health, Science and Technology, Aalborg University, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Gislason
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark; Prehospital Emergency Medical Services: The Capital Region of Denmark, Copenhagen, Denmark.
authors.forename: Mads
authors.initials: M
authors.lastname: Wissenberg
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D015897:Comorbidity; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000401:mortality*; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
keywords: CPR; Chronic obstructive pulmonary disease; Heart rhythm; Improvements; Out-of-hospital cardiac arrest; Survival