Trends and Outcomes in Opioid Related Cardiac Arrest in a Contemporary US Population From 2012-18

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European Heart Journal





Opioid abuse is a significant problem and has been associated in patients presenting with cardiac arrest. We aimed to investigate and compare the contemporary trends of cardiac arrest in patients with and without opioid abuse. Methods

All hospitalizations for primary diagnosis of Cardiac arrest between 2012 and 2018 identified in the Nationwide Readmissions Database were categorized into those with or without a secondary diagnosis of opioid disease. Cardiac arrest hospitalizations with opioid use using the year of admission, discharge quarter, age, sex, and elixhauser comorbidity index. Primary outcomes were inpatient mortality. Survey techniques were used to do comparative analyses using Stata 16.0. Results

Of 1,410,475 cardiac arrest hospitalizations that met inclusion criteria, 43,090 (3.1%) had cardiac arrest with a secondary diagnosis of opioid use. In hospital mortality in cardiac arrest patients with and without opioid use was 56.7% vs 61.2%. Hospitalizations for cardiac arrest with opioid use were associated with higher prevalence of alcohol (16.9% vs. 7.1%; p<0.05), depression (18.8% vs. 9%; p<0.05), and smoking (37.0% vs. 21.8%; p<0.05) as compared with cardiac arrest without opioid use. Hospitalizations for cardiac arrest with opioid use was seen less likely in patients with heart failure (21.2% vs. 40.6%; p<0.05), diabetes mellitus (19.5% vs. 35.4%; p<0.05), hypertension (43.4% vs. 64.9%; p<0.05) and renal failure (14.3% vs. 30.2%; p<0.05). Over the last 7 years, there has been a significant increasing trend in opioid associated cardiac arrest (p for trend <0.05) see figure. Conclusions

Opioid remains a significant cause of cardiac arrests in the contemporary US population with an increase in its incidence over last 7 years. Lifestyle choices is most attributing to this increasing trend. Opioid users that presented with cardiac arrest were twice as more likely to have depression.