Trends in presumed drug overdose out-of-hospital cardiac arrests in San Francisco, 2015–2023
Estimates of the prevalence of drug-related out of hospital cardiac arrest (OHCA) vary, ranging from 1.8% to 10.0% of medical OHCA. However, studies conducted prior to the recent wave of fentanyl deaths likely underestimate the current prevalence of drug-related OHCA. We evaluated recent trends in d...
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Published in | Resuscitation Vol. 198; p. 110159 |
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Abstract | Estimates of the prevalence of drug-related out of hospital cardiac arrest (OHCA) vary, ranging from 1.8% to 10.0% of medical OHCA. However, studies conducted prior to the recent wave of fentanyl deaths likely underestimate the current prevalence of drug-related OHCA. We evaluated recent trends in drug-related OHCA, hypothesizing that the proportion of presumed drug-related OHCA treated by emergency medical services (EMS) has increased since 2015.
We conducted a retrospective analysis of OHCA patients treated by EMS providers in San Francisco, California between 2015 and 2023. Participants included OHCA cases in which resuscitation was attempted by EMS. The study exposure was the year of arrest. Our primary outcome was the occurrence of drug-related OHCA, defined as the EMS impression of OHCA caused by a presumed or known overdose of medication(s) or drug(s).
From 2015 to 2023, 5044 OHCA resuscitations attended by EMS (average 561 per year) met inclusion criteria. The median age was 65 (IQR 50–79); 3508 (69.6%) were male. The EMS impression of arrest etiology was drug-related in 446/5044 (8.8%) of OHCA. The prevalence of presumed drug-related OHCA increased significantly each year from 1% in 2015 to 17.6% in 2023 (p-value for trend = 0.0001). After adjustment, presumed drug-related OHCA increased by 30% each year from 2015-2023.
Drug-related OHCA is an increasingly common etiology of OHCA. In 2023, one in six OHCA was presumed to be drug related. Among participants less than 60 years old, one in three OHCA was presumed to be drug related. |
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AbstractList | Estimates of the prevalence of drug-related out of hospital cardiac arrest (OHCA) vary, ranging from 1.8% to 10.0% of medical OHCA. However, studies conducted prior to the recent wave of fentanyl deaths likely underestimate the current prevalence of drug-related OHCA. We evaluated recent trends in drug-related OHCA, hypothesizing that the proportion of presumed drug-related OHCA treated by emergency medical services (EMS) has increased since 2015.INTRODUCTIONEstimates of the prevalence of drug-related out of hospital cardiac arrest (OHCA) vary, ranging from 1.8% to 10.0% of medical OHCA. However, studies conducted prior to the recent wave of fentanyl deaths likely underestimate the current prevalence of drug-related OHCA. We evaluated recent trends in drug-related OHCA, hypothesizing that the proportion of presumed drug-related OHCA treated by emergency medical services (EMS) has increased since 2015.We conducted a retrospective analysis of OHCA patients treated by EMS providers in San Francisco, California between 2015 and 2023. Participants included OHCA cases in which resuscitation was attempted by EMS. The study exposure was the year of arrest. Our primary outcome was the occurrence of drug-related OHCA, defined as the EMS impression of OHCA caused by a presumed or known overdose of medication(s) or drug(s).METHODSWe conducted a retrospective analysis of OHCA patients treated by EMS providers in San Francisco, California between 2015 and 2023. Participants included OHCA cases in which resuscitation was attempted by EMS. The study exposure was the year of arrest. Our primary outcome was the occurrence of drug-related OHCA, defined as the EMS impression of OHCA caused by a presumed or known overdose of medication(s) or drug(s).From 2015 to 2023, 5044 OHCA resuscitations attended by EMS (average 561 per year) met inclusion criteria. The median age was 65 (IQR 50-79); 3508 (69.6%) were male. The EMS impression of arrest etiology was drug-related in 446/5044 (8.8%) of OHCA. The prevalence of presumed drug-related OHCA increased significantly each year from 1% in 2015 to 17.6% in 2023 (p-value for trend = 0.0001). After adjustment, presumed drug-related OHCA increased by 30% each year from 2015-2023.RESULTSFrom 2015 to 2023, 5044 OHCA resuscitations attended by EMS (average 561 per year) met inclusion criteria. The median age was 65 (IQR 50-79); 3508 (69.6%) were male. The EMS impression of arrest etiology was drug-related in 446/5044 (8.8%) of OHCA. The prevalence of presumed drug-related OHCA increased significantly each year from 1% in 2015 to 17.6% in 2023 (p-value for trend = 0.0001). After adjustment, presumed drug-related OHCA increased by 30% each year from 2015-2023.Drug-related OHCA is an increasingly common etiology of OHCA. In 2023, one in six OHCA was presumed to be drug related. Among participants less than 60 years old, one in three OHCA was presumed to be drug related.CONCLUSIONDrug-related OHCA is an increasingly common etiology of OHCA. In 2023, one in six OHCA was presumed to be drug related. Among participants less than 60 years old, one in three OHCA was presumed to be drug related. Estimates of the prevalence of drug-related out of hospital cardiac arrest (OHCA) vary, ranging from 1.8% to 10.0% of medical OHCA. However, studies conducted prior to the recent wave of fentanyl deaths likely underestimate the current prevalence of drug-related OHCA. We evaluated recent trends in drug-related OHCA, hypothesizing that the proportion of presumed drug-related OHCA treated by emergency medical services (EMS) has increased since 2015. We conducted a retrospective analysis of OHCA patients treated by EMS providers in San Francisco, California between 2015 and 2023. Participants included OHCA cases in which resuscitation was attempted by EMS. The study exposure was the year of arrest. Our primary outcome was the occurrence of drug-related OHCA, defined as the EMS impression of OHCA caused by a presumed or known overdose of medication(s) or drug(s). From 2015 to 2023, 5044 OHCA resuscitations attended by EMS (average 561 per year) met inclusion criteria. The median age was 65 (IQR 50–79); 3508 (69.6%) were male. The EMS impression of arrest etiology was drug-related in 446/5044 (8.8%) of OHCA. The prevalence of presumed drug-related OHCA increased significantly each year from 1% in 2015 to 17.6% in 2023 (p-value for trend = 0.0001). After adjustment, presumed drug-related OHCA increased by 30% each year from 2015-2023. Drug-related OHCA is an increasingly common etiology of OHCA. In 2023, one in six OHCA was presumed to be drug related. Among participants less than 60 years old, one in three OHCA was presumed to be drug related. Estimates of the prevalence of drug-related out of hospital cardiac arrest (OHCA) vary, ranging from 1.8 - 10.0% of medical OHCA. However, studies conducted prior to the recent wave of fentanyl deaths likely underestimate the current prevalence of drug-related OHCA. We evaluated recent trends in drug-related OHCA, hypothesizing that the proportion of presumed drug-related OHCA treated by emergency medical services (EMS) has increased since 2015. We conducted a retrospective analysis of OHCA patients treated by EMS providers in San Francisco, California between 2015 - 2023. Participants included OHCA cases in which resuscitation was attempted by EMS. The study exposure was the year of arrest. Our primary outcome was the occurrence of drug-related OHCA, defined as the EMS impression of OHCA caused by a presumed or known overdose of medication(s) or drug(s). From 2015 to 2023, 5044 OHCA resuscitations attended by EMS (average 561 per year) met inclusion criteria. The median age was 65 (IQR 50-79); 3508 (69.6%) were male. The EMS impression of arrest etiology was drug-related in 446/5044 (8.8%) of OHCA. The prevalence of presumed drug-related OHCA increased significantly each year from 1% in 2015 to 17.6% in 2023 (p-value for trend = 0.0001). After adjustment, presumed drug-related OHCA increased by 30% each year from 2015-2023. Drug-related OHCA is an increasingly common etiology of OHCA. In 2023, one in six OHCA was presumed to be drug related. Among participants less than 60 years old, one in three OHCA was presumed to be drug related. |
ArticleNumber | 110159 |
Author | Wang, Ralph C. Menegazzi, James J. Dillon, David G. Rodriguez, Robert M. Montoy, Juan Carlos C. Lacocque, Jeremy |
AuthorAffiliation | a Department of Emergency Medicine, University of California, San Francisco, USA b Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, USA c Department of Emergency Medicine, University of California, Davis, USA |
AuthorAffiliation_xml | – name: b Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, USA – name: a Department of Emergency Medicine, University of California, San Francisco, USA – name: c Department of Emergency Medicine, University of California, Davis, USA |
Author_xml | – sequence: 1 givenname: Ralph C. surname: Wang fullname: Wang, Ralph C. email: ralph.wang@ucsf.edu organization: Department of Emergency Medicine, University of California, San Francisco, USA – sequence: 2 givenname: Juan Carlos C. surname: Montoy fullname: Montoy, Juan Carlos C. organization: Department of Emergency Medicine, University of California, San Francisco, USA – sequence: 3 givenname: Robert M. surname: Rodriguez fullname: Rodriguez, Robert M. organization: Department of Emergency Medicine, University of California, San Francisco, USA – sequence: 4 givenname: James J. surname: Menegazzi fullname: Menegazzi, James J. organization: Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, USA – sequence: 5 givenname: Jeremy surname: Lacocque fullname: Lacocque, Jeremy organization: Department of Emergency Medicine, University of California, San Francisco, USA – sequence: 6 givenname: David G. surname: Dillon fullname: Dillon, David G. organization: Department of Emergency Medicine, University of California, Davis, USA |
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Cites_doi | 10.1016/j.resuscitation.2014.05.036 10.2307/3001775 10.1001/jamanetworkopen.2022.14351 10.1056/NEJMc2304991 10.1371/journal.pone.0176441 10.1016/j.resuscitation.2018.06.024 10.1001/jamapsychiatry.2020.4218 10.5210/ojphi.v11i1.9714 10.1001/jamapsychiatry.2021.0967 10.1016/j.resuscitation.2020.12.009 10.1161/CIR.0000000000000958 10.1016/j.annemergmed.2009.03.018 10.1016/j.resuscitation.2015.01.028 10.1016/S0196-0644(05)80651-1 10.7326/M20-0977 10.1161/CIR.0000000000001161 10.1016/j.resuscitation.2018.10.019 10.1016/j.resuscitation.2015.11.010 10.1016/j.resuscitation.2006.06.040 |
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Keywords | Drug related cardiac arrest Opioid overdose opioid overdose drug related cardiac arrest |
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Snippet | Estimates of the prevalence of drug-related out of hospital cardiac arrest (OHCA) vary, ranging from 1.8% to 10.0% of medical OHCA. However, studies conducted... Estimates of the prevalence of drug-related out of hospital cardiac arrest (OHCA) vary, ranging from 1.8 - 10.0% of medical OHCA. However, studies conducted... |
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SubjectTerms | Drug related cardiac arrest Opioid overdose |
Title | Trends in presumed drug overdose out-of-hospital cardiac arrests in San Francisco, 2015–2023 |
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