Purpose of the study
The population of cancer survivors is growing, with a following increased risk of cardiovascular death (1). The association between cancer and out-of-hospital cardiac arrest (OHCA) survival has not been thoroughly investigated. In this study, we used national, population-based registries to address this knowledge gap.
Material and methods
For this study, OHCA cases among adults (≥18 years) 2010-2017 were obtained from the Swedish Register of Cardiopulmonary Resuscitation, and linked to the National Patient Registry for identification of cancer diagnosed within 5 years prior to the arrest. Differences between cancer patients and controls (defined as OHCA-patients without cancer diagnosis ever) was assessed using multiple logistic regression adjusted for prognostic factors for short-term survival, and Kaplan-Meier analysis for long-term survival.
Results
A total of 30,163 OHCA patients were included, 2894 (10%) with pre-OHCA cancer diagnosis and 27,691 without (controls). Pre-OHCA cancer was associated with decreased short-term survival for cancer of all sites (adjusted odds ratio, OR 0.57, CI 0.49-0.66), locoregional cancer (OR 0.71, CI 0.6- 0.84) and metastasized cancer (OR 0.26, CI 0.16-0.44) compared to controls. A decrease in short-term survival compared to controls was seen for lung cancer, gastrointestinal-, hematological-, and gynecological cancers. Among 30-day survivors, those with locoregional cancer as well as metastasized cancer, had poorer long-term survival compared to controls.
Conclusion
Pre-OHCA cancer was associated with decreased short- and long-term survival regardless of cancer spread compared to controls, although with markedly poorer prognosis for metastasized disease. Short-term survival varied by cancer form. These results suggest that cancer site and cancer spread are more relevant factors than cancer in general regarding its effect associated to survival.
1. Blaes AH, Shenoy C. Is it time to include cancer in cardiovascular risk prediction tools?. Lancet. 2019;394(10203):986-988.

Increased Risk of Death after Out-of-Hospital Cardiac Arrest among Cancer Patients

Implementation of the Guidelines - How do we put the new ERC Guidelines into practice?

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