Prognosis of cardiac arrest in home care clients and nursing home residents: A population-level retrospective cohort study


Mowbray F. I., Jones A., Strum R. P., Turcotte L., Foroutan F., de Wit K., ...Daha Fazla

Resuscitation Plus, cilt.12, 2022 (Scopus) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 12
  • Basım Tarihi: 2022
  • Doi Numarası: 10.1016/j.resplu.2022.100328
  • Dergi Adı: Resuscitation Plus
  • Derginin Tarandığı İndeksler: Scopus
  • Anahtar Kelimeler: Cardiac arrest, Home care, Nursing home, Prognosis, Survival
  • TED Üniversitesi Adresli: Hayır

Özet

© 2022 The AuthorsAim: To evaluate the prognosis of 30-day survival post-cardiac arrest among patients receiving home care and nursing home residents. Methods: We conducted a population-level retrospective cohort study of community-dwelling adults (≥18 years) who received cardiac arrest care at a hospital in Ontario, Canada, between 2006 to 2018. We linked population-based health datasets using the Home Care Dataset to identify patients receiving home care and the Continuing Care Reporting System to identify nursing home residents. We included both out-of-hospital and in-hospital cardiac arrests. We determined unadjusted and adjusted associations using logistic regression after adjusting for age and sex. We converted relative measures to absolute risks. Results: Our cohort contained 86,836 individuals. Most arrests (55.5 %) occurred out-of-hospital, with 9,316 patients enrolled in home care and 2,394 residing in a nursing home. When compared to those receiving no support services, the likelihood of survival to 30-days was lower for those receiving home care (RD = −6.5; 95 %CI = −7.5 – −5.0), with similar results found within sub-groups of out-of-hospital (RD = −6.7; 95 %CI = −7.6 – −5.7) and in-hospital arrests (RD = −8.7; 95 %CI = −10.6 – −7.3). The likelihood of 30-day survival was lower for nursing home residents (RD = −7.2; 95 %CI = −9.3 - −5.3) with similar results found within sub-groups of out-of-hospital (RD = −8.6; 95 %CI = −10.6 – −5.7) and in-hospital arrests (RD = −5.0; 95 %CI = −7.8 – −2.1). Conclusion: Patients receiving home care and nursing home residents had worse overall prognoses of survival post-cardiac arrest compared to those receiving no pre-arrest support, highlighting two medically-complex groups likely to benefit from advance care planning.