Universität zu Köln

Finke, K. ORCID: 0000-0002-4710-8508, Meertens, M.M. ORCID: 0000-0002-7746-8723, Macherey-Meyer, S. ORCID: 0000-0002-7080-6611, Heyne, S. ORCID: 0000-0002-1581-9954, Braumann, S. ORCID: 0000-0002-9969-6073, Baldus, S. ORCID: 0000-0001-8259-1737, Lee, S. ORCID: 0000-0001-6768-7079 and Adler, C. ORCID: 0000-0002-2879-3837 (2024). Exercise related versus non exercise related out of hospital cardiac arrest – A retrospective single-center study. Resuscitation Plus, 19. pp. 1-7. Elsevier. ISSN 2666-5204

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Abstract

Background: Physical activity prevents cardiovascular disease, but it may also trigger acute cardiac events like sudden cardiac death in patients with underlying heart disease. The chance of surviving an out-of-hospital cardiac arrest remains low, despite improving medical treatment and rescue chain. Prior studies signaled increased survival in exercise related out-of-hospital cardiac arrest. Objective: The aim of this study was to evaluate the differences between exercise related out-of-hospital cardiac arrest and out-of-hospital cardiac arrest during daily activity in an urban setting. Methods: Retrospective analysis of all out-of-hospital cardiac arrests from 2014 to 2021 treated at a cardiac arrest center of a tertiary hospital. The primary outcome was survival to discharge. Secondary outcomes included differences in pre-hospital care, in-hospital treatment, hypoxic ischemic encephalopathy, and laboratory parameters. Results: 478 OHCA patients were reviewed of which 432 patients (exercise related 36 (8.4%) vs. daily activity 396 (91.6%)) were included in the analysis. Patients suffering an exercise related arrest were younger (57 vs 65 years, p = 0.002) and mostly male (88.9 vs 74.5%, p = 0.054). The exercise related cohort received bystander cardiopulmonary resuscitation (77.8 vs 53.4%, p = 0.005) to a higher extent and had a shorter no-flow time (1.5 vs 2 min, p = 0.049). Exercise related arrest patients more often presented with a shockable rhythm (80.6 vs 64.1%, p = 0.032). At hospital admission exercise related arrest patients had a higher initial pH (7.24 vs 7.19, p = 0.015). In the exercise related group, a cardiac cause was numerically more frequent compared to the daily activity group (80.6 vs 68.7%, p = 0.09). In both groups myocardial infarction (47.2 vs 43.2%) was the most common cause, but a primary arrhythmic event (33.3 vs 25.5%) was more often documented in exercise related arrest patients. Exercise related arrest was mostly related to endurance training (52.8%) followed by ball sports (19.4%) and occurred directly during exercise in 77.8% of cases. Patients suffering exercise related arrest had higher survival till discharge (66.7 vs 47.7%, p = 0.036). Conclusion: Based on this observational data from a highly selected group of out-of-hospital cardiac arrest patients treated at a cardiac arrest center, patients suffering an exercise related out-of-hospital cardiac arrest, differed in substantial characteristics and in the first line response compared to daily activity out-of-hospital cardiac arrest patients. The better survival to discharge of the exercise related out-of-hospital cardiac arrest group might be driven by these beneficial differences. This study underlines the need for public awareness for the importance of a fast first response and a broad distribution of automated external defibrillators in public sport areas since most of the exercise related out-of-hospital cardiac arrest patients presented with a cardiac cause and an initial shockable rhythm.

Item Type:	Article
Creators:	Creators Email ORCID ORCID Put Code Finke, K. UNSPECIFIED https://orcid.org/0000-0002-4710-8508 UNSPECIFIED Meertens, M.M. UNSPECIFIED https://orcid.org/0000-0002-7746-8723 UNSPECIFIED Macherey-Meyer, S. UNSPECIFIED https://orcid.org/0000-0002-7080-6611 UNSPECIFIED Heyne, S. UNSPECIFIED https://orcid.org/0000-0002-1581-9954 UNSPECIFIED Braumann, S. UNSPECIFIED https://orcid.org/0000-0002-9969-6073 UNSPECIFIED Baldus, S. UNSPECIFIED https://orcid.org/0000-0001-8259-1737 UNSPECIFIED Lee, S. UNSPECIFIED https://orcid.org/0000-0001-6768-7079 UNSPECIFIED Adler, C. UNSPECIFIED https://orcid.org/0000-0002-2879-3837 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-814323
Identification Number:	10.1016/j.resplu.2024.100742
Journal or Publication Title:	Resuscitation Plus
Volume:	19
Page Range:	pp. 1-7
Number of Pages:	7
Date:	September 2024
Publisher:	Elsevier
ISSN:	2666-5204
Language:	English
Faculty:	Faculty of Medicine
Divisions:	Faculty of Medicine > Innere Medizin > Klinik III für Innere Medizin - Kardiologie, Pneumologie, Angiologie und internistische Intensivmedizin
Subjects:	Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language Out of hospital cardiac arrest ; Sudden cardiac arrest ; Exercise ; Myocardial infarction ; Sport ; Sudden cardiac death English
['eprint_fieldname_oa_funders' not defined]:	Publikationsfonds UzK
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/81432