Citation

Shin SD, Park JH, Song KJ, Park CB, Ro YS, Kwak YH. Resuscitation 2012; 83(1): 51-57.

Affiliation

Department of Emergency Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-Gu, Seoul 110-744, Korea; Department of Emergency Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-Gu, Seoul 110-744, Korea; Department of Emergency Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-Gu, Seoul 110-744, Korea; Department of Emergency Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-Gu, Seoul 110-744, Korea; Department of Preventive Medicine, Seoul National University School of Public Health, 56-1 Sillim-Dong, Kwanak-Gu, Seoul 151-741, Korea; Department of Emergency Medicine, Seoul National University College of Medicine, 101 Daehakro, Jongno-Gu, Seoul 110-744, Korea.

Copyright

(Copyright © 2012, Elsevier Publishing)

DOI

10.1016/j.resuscitation.2011.07.005

PMID

21762666

Abstract

OBJECTIVES: 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 etiology 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). Conclusion Using a nationwide OHCA registry, we found that poisonings were responsible for 4.4% of OHCAs of a non-cardiac etiology. Ingestion of insecticides including organophosphate and carbamate was associated with more favorable outcomes.

Language: en