Out-of-hospital cardiac arrests in young adults in Melbourne, Australia-Adding coronial data to a cardiac arrest registry

Aim: We aim to describe the coronial findings of young adults where the out-of-hospital cardiac arrest (OHCA) aetiology was 'presumed cardiac'. Methods: Presumed cardiac aetiology OHCAs occurring in young adults aged 16-39 years were identified using the Victorian Ambulance Cardiac Arrest...

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Main Authors: Deasy, C., Bray, Janet, Smith, K., Harriss, L., Bernard, S., Cameron, P.
Format: Journal Article
Published: 2011
Online Access:http://hdl.handle.net/20.500.11937/8197
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author Deasy, C.
Bray, Janet
Smith, K.
Harriss, L.
Bernard, S.
Cameron, P.
author_facet Deasy, C.
Bray, Janet
Smith, K.
Harriss, L.
Bernard, S.
Cameron, P.
author_sort Deasy, C.
building Curtin Institutional Repository
collection Online Access
description Aim: We aim to describe the coronial findings of young adults where the out-of-hospital cardiac arrest (OHCA) aetiology was 'presumed cardiac'. Methods: Presumed cardiac aetiology OHCAs occurring in young adults aged 16-39 years were identified using the Victorian Ambulance Cardiac Arrest Registry (VACAR) and available coronial findings reviewed. Results: We identified 841 young adult OHCAs where the Utstein aetiology was 'presumed cardiac'. Of these 740 died and 572 (77%) OHCAs were matched to coroner's findings. On review of the coroner's cause of death, 230 (40.2%) had a 'confirmed cardiac' aetiology, 221 (38.6%) were proven 'non-cardiac', 97 (17%) were inconclusive and 24 (4.2%) cases remained 'open'.'Confirmed cardiac' causes of OHCA were ischemic heart disease (n=126, 55%), cardiomegaly (n=26, 11.3%), cardiomyopathy (n=25, 11%), congenital heart disease (n=15, 6.5%), cardiac tamponade due to dissecting thoracic aorta aneurysm (n=10, 4.3%), myocarditis (n=8, 3.5%), arrhythmia (n=7, 3%), others (n=13, 5.7%).'Non-cardiac' causes of OHCA were epilepsy/sudden unexplained death in epilepsy (SUDEP) (n=56, 25%), pulmonary embolism (n=29, 13%), subarachnoid haemorrhage (n=17, 7.7%), other intracranial bleed (n=7, 3.2%), pneumonia (n=17, 7.7%), DKA (n=16, 7.2%), other complications of diabetes mellitus (n=8, 3.6%), complications of obesity (n=9, 4%), haemorrhage (n=12, 5.4%), sepsis (n=8, 3.6%), peritonitis (n=6, 2.7%), aspiration (n=6, 2.7%), renal failure (n=5, 2.3%), asthma (n=5, 2.3%), complications of anorexia (n=3) and alcohol abuse (n=2), thyrotoxicosis (n=2), meningitis (n=1) and others (n=12).Compared with coroner's diagnosed 'non-cardiac' OHCAs, 'confirmed cardiac' were more likely to be witnessed (41% vs 23%, p=. 0.01), receive bystander CPR (35% vs 20%, p=. 0.001), have a shockable rhythm (27% vs 6.3%, p<0.001) and have EMS attempted resuscitation (62% vs 44%, p<0.001). Discussion: Linking OHCA registries with coronial databases for aetiology of the arrest will improve the quality of the data and should be considered by all OHCA registries, particularly for young adult OHCA. © 2011 Elsevier Ireland Ltd.
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spelling curtin-20.500.11937-81972017-09-13T14:34:29Z Out-of-hospital cardiac arrests in young adults in Melbourne, Australia-Adding coronial data to a cardiac arrest registry Deasy, C. Bray, Janet Smith, K. Harriss, L. Bernard, S. Cameron, P. Aim: We aim to describe the coronial findings of young adults where the out-of-hospital cardiac arrest (OHCA) aetiology was 'presumed cardiac'. Methods: Presumed cardiac aetiology OHCAs occurring in young adults aged 16-39 years were identified using the Victorian Ambulance Cardiac Arrest Registry (VACAR) and available coronial findings reviewed. Results: We identified 841 young adult OHCAs where the Utstein aetiology was 'presumed cardiac'. Of these 740 died and 572 (77%) OHCAs were matched to coroner's findings. On review of the coroner's cause of death, 230 (40.2%) had a 'confirmed cardiac' aetiology, 221 (38.6%) were proven 'non-cardiac', 97 (17%) were inconclusive and 24 (4.2%) cases remained 'open'.'Confirmed cardiac' causes of OHCA were ischemic heart disease (n=126, 55%), cardiomegaly (n=26, 11.3%), cardiomyopathy (n=25, 11%), congenital heart disease (n=15, 6.5%), cardiac tamponade due to dissecting thoracic aorta aneurysm (n=10, 4.3%), myocarditis (n=8, 3.5%), arrhythmia (n=7, 3%), others (n=13, 5.7%).'Non-cardiac' causes of OHCA were epilepsy/sudden unexplained death in epilepsy (SUDEP) (n=56, 25%), pulmonary embolism (n=29, 13%), subarachnoid haemorrhage (n=17, 7.7%), other intracranial bleed (n=7, 3.2%), pneumonia (n=17, 7.7%), DKA (n=16, 7.2%), other complications of diabetes mellitus (n=8, 3.6%), complications of obesity (n=9, 4%), haemorrhage (n=12, 5.4%), sepsis (n=8, 3.6%), peritonitis (n=6, 2.7%), aspiration (n=6, 2.7%), renal failure (n=5, 2.3%), asthma (n=5, 2.3%), complications of anorexia (n=3) and alcohol abuse (n=2), thyrotoxicosis (n=2), meningitis (n=1) and others (n=12).Compared with coroner's diagnosed 'non-cardiac' OHCAs, 'confirmed cardiac' were more likely to be witnessed (41% vs 23%, p=. 0.01), receive bystander CPR (35% vs 20%, p=. 0.001), have a shockable rhythm (27% vs 6.3%, p<0.001) and have EMS attempted resuscitation (62% vs 44%, p<0.001). Discussion: Linking OHCA registries with coronial databases for aetiology of the arrest will improve the quality of the data and should be considered by all OHCA registries, particularly for young adult OHCA. © 2011 Elsevier Ireland Ltd. 2011 Journal Article http://hdl.handle.net/20.500.11937/8197 10.1016/j.resuscitation.2011.05.031 restricted
spellingShingle Deasy, C.
Bray, Janet
Smith, K.
Harriss, L.
Bernard, S.
Cameron, P.
Out-of-hospital cardiac arrests in young adults in Melbourne, Australia-Adding coronial data to a cardiac arrest registry
title Out-of-hospital cardiac arrests in young adults in Melbourne, Australia-Adding coronial data to a cardiac arrest registry
title_full Out-of-hospital cardiac arrests in young adults in Melbourne, Australia-Adding coronial data to a cardiac arrest registry
title_fullStr Out-of-hospital cardiac arrests in young adults in Melbourne, Australia-Adding coronial data to a cardiac arrest registry
title_full_unstemmed Out-of-hospital cardiac arrests in young adults in Melbourne, Australia-Adding coronial data to a cardiac arrest registry
title_short Out-of-hospital cardiac arrests in young adults in Melbourne, Australia-Adding coronial data to a cardiac arrest registry
title_sort out-of-hospital cardiac arrests in young adults in melbourne, australia-adding coronial data to a cardiac arrest registry
url http://hdl.handle.net/20.500.11937/8197