J Korean Med Sci.  2017 Dec;32(12):2042-2050. 10.3346/jkms.2017.32.12.2042.

Poisoning-induced Out-of-Hospital Cardiac Arrest and Outcomes according to Poison Agent

• Kim M
• Shin SD
• Jeong S
• Kwak YH
• Suh GJ

• KMID: 2396384
• DOI: http://doi.org/10.3346/jkms.2017.32.12.2042

Abstract

It is unclear whether specific agent groups are associated with outcomes in cases of poisoning-induced out-of-hospital cardiac arrest (P-OHCA). The study population comprised cases of confirmed P-OHCA drawn from the national out-of-hospital cardiac arrest (OHCA) registry (2008-2013). Exposures were categorized into five groups according to the International Classification of Disease, 10th version: group 1, prescribed drugs; group 2, vapors and gases; group 3, pesticides; group 4, alcohol and organic solvents; and group 5, other poisons. The outcome was survival to discharge and good neurological recovery. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated to test the association between specific groups and outcomes. A total of 2,083 patients were analyzed; group 1 (10.3%), group 2 (23.6%), group 3 (52.9%), group 4 (1.4%), and group 5 (13.2%). The survival to discharge and good neurological recovery rates were 3.3%/1.3% for all patients, 10.3%/5.6% (group 1), 6.9%/3.4% (group 2), 2.4%/0.4% (group 3), 2.2%/1.0% (group 4), and 3.3%/2.4% (group 5) (all P < 0.001). The aORs (95% CIs) of groups 2-5 compared with group 1 for survival to discharge were 0.47 (0.09-2.51), 0.34 (0.17-0.68), 0.33 (0.14-0.77), and 0.31 (0.13-0.77), respectively. The odds ratios (95% CIs) for good neurological recovery were significant only in group 1, the pesticides group (0.07 [0.02-0.26]) and were not significant in the other groups. P-OHCA outcomes differed significantly among the poisoning agent groups. The pesticides group showed the worst outcomes, followed by the group of vapors or gases.

Keyword

Poison; Cardiac Arrest; Survival; Pesticides; Vapors; Gases

MeSH Terms

Classification
Gases
Heart Arrest
Humans
Odds Ratio
Out-of-Hospital Cardiac Arrest*
Pesticides
Poisoning
Poisons
Solvents
Gases
Pesticides
Poisons
Solvents

Figure

• 

  Fig. 1 Study participants. EMS = emergency medical service, OHCA = out-of-hospital cardiac arrest, P-OHCA = poisoning-induced out-of-hospital cardiac arrest, CPC = cerebral performance category.

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