title: Association between bystander cardiopulmonary resuscitation and redeemed prescriptions for antidepressants and anxiolytics in out-of-hospital cardiac arrest survivors.
abstract: This study aimed to examine rates of redeemed prescriptions of antidepressants and anxiolytics, used as markers for cerebral dysfunction in out-of-hospital cardiac arrest (OHCA) survivors, and examine the association between bystander CPR and these psychoactive drugs.
  
  
  
  We included all 30-day survivors of OHCA in Denmark between 2001 and 2011, who had not redeemed prescriptions for antidepressants or anxiolytics in the last six months prior to OHCA. Main outcome measures were redeemed prescriptions of antidepressants and anxiolytics within one year after OHCA.
  
  
  
  Among 2,001 30-day survivors, 174 (8.6% died and 12.0% redeemed a first prescription for an antidepressant and 8.2% for an anxiolytic drug within one year after arrest. The corresponding frequencies for redeemed prescribed drugs among age- and sex-matched population controls were 7.5% and 5.2%, respectively. Among survivors who received bystander CPR, prescriptions for antidepressants and anxiolytics were redeemed in 11.1% [95% CI 9.2-13.3%] and 6.3% [95% CI 4.9-8.0%] of the cases, respectively, versus 17.2% [95% CI 13.9-21.1%] and 13.4% [95% CI 10.5-17.0%], respectively, among patients who had not received bystander CPR. Adjusted for age, sex, year of arrest, comorbidity, witnessed status and socioeconomic status, bystander CPR was associated with significant reductions in redeemed prescriptions for antidepressants, Hazard Ratio (HR) 0.71 [95% CI 0.52-0.98], P=0.031; and anxiolytics, HR 0.55 [95% CI 0.38-0.81], P=0.002.
  
  
  
  Relative to no bystander CPR, redeemed prescriptions for antidepressants and anxiolytics were significantly lower among 30-day survivors of OHCA who received bystander CPR, suggesting a cerebral dysfunction-lowering potential of bystander CPR.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Aalborg University Hospital, Denmark. Electronic address: kristian.bundgaard@rn.dk.
authors.forename: Kristian
authors.initials: K
authors.lastname: Bundgaard
authors.affiliation: Department of Health Science and Technology, Aalborg University, Denmark; Department of Clinical Epidemiology, Aalborg University Hospital, Denmark.
authors.forename: Steen M
authors.initials: SM
authors.lastname: Hansen
authors.affiliation: Department of Clinical Epidemiology, Aalborg University Hospital, Denmark.
authors.forename: Rikke Nørmark
authors.initials: RN
authors.lastname: Mortensen
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark; Emergency Medical Services, Copenhagen and University of Copenhagen, Denmark.
authors.forename: Mads
authors.initials: M
authors.lastname: Wissenberg
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark.
authors.forename: Malta
authors.initials: M
authors.lastname: Hansen
authors.affiliation: Emergency Medical Services, Copenhagen and University of Copenhagen, Denmark.
authors.forename: Freddy
authors.initials: F
authors.lastname: Lippert
authors.affiliation: Department of Cardiology, Copenhagen University Hospital Gentofte, Denmark; The Danish Heart Foundation, Copenhagen, Denmark; The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark.
authors.forename: Gunnar
authors.initials: G
authors.lastname: Gislason
authors.affiliation: The Heart Centre, Copenhagen University Hospital Rigshospitalet, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Køber
authors.affiliation: Mental Health Centre Glostrup, Copenhagen University Hospital, Copenhagen, Denmark.
authors.forename: Jimmi
authors.initials: J
authors.lastname: Nielsen
authors.affiliation: Department of Health Science and Technology, Aalborg University, Denmark; Department of Clinical Epidemiology, Aalborg University Hospital, Denmark.
authors.forename: Christian
authors.initials: C
authors.lastname: Torp-Pedersen
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark.
authors.forename: Bodil Steen
authors.initials: BS
authors.lastname: Rasmussen
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Aalborg University Hospital, Denmark; Department of Clinical Medicine, Aalborg University, Denmark.
authors.forename: Kristian
authors.initials: K
authors.lastname: Kragholm
mesh_terms: D000367:Age Factors; D000368:Aged; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D016887:Cardiopulmonary Resuscitation / Q000523:psychology* / Q000706:statistics & numerical data; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000523:psychology / Q000628:therapy*; D016016:Proportional Hazards Models; D012042:Registries; D017741:Survivors / Q000523:psychology; D013997:Time Factors
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents
keywords: Antidepressant; Anxiolytic; Bystander cardiopulmonary resuscitation; Out-of-hospital cardiac arrest