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Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort study.

Publication ,  Journal Article
Ho, AFW; Lim, MJR; Earnest, A; Blewer, A; Graves, N; Yeo, JW; Pek, PP; Tiah, L; Ong, MEH; Singapore PAROS Investigators,
Published in: Lancet Reg Health West Pac
March 2023

BACKGROUND: Understanding the long-term outcomes and disability-adjusted life years (DALY) after out-of-hospital cardiac arrest (OHCA) is important to understand the overall health and disease burden of OHCA respectively, but data in Asia remains limited. We aimed to quantify long-term survival and the annual disease burden of OHCA within a national multi-ethnic Asian cohort. METHODS: We conducted an open cohort study linking the Singapore Pan-Asian Resuscitation Outcomes Study (PAROS) and the Singapore Registry of Births and Deaths from 2010 to 2019. We performed Cox regression, constructed Kaplan-Meier curves, and calculated DALYs and standardised mortality ratios (SMR) for each year of follow-up. RESULTS: We analysed 802 cases. The mean age was 56.0 (SD 17.8). Most were male (631 cases, 78,7%) and of Chinese ethnicity (552 cases, 68.8%). At one year, the SMR was 14.9 (95% CI:12.5-17.8), decreasing to 1.2 (95% CI:0.7-1.8) at three years, and 0.4 (95% CI:0.2-0.8) at five years. Age at arrest (HR:1.03, 95% CI:1.02-1.04, p < 0.001), shockable presenting rhythm (HR:0.75, 95% CI:0.52-0.93, p = 0.015) and CPC category (HR:4.62, 95% CI:3.17-6.75, p < 0.001) were independently associated with mortality. Annual DALYs due to OHCA varied from 304.1 in 2010 to 849.7 in 2015, then 547.1 in 2018. Mean DALYs decreased from 12.162 in 2010 to 3.599 in 2018. CONCLUSIONS: OHCA survivors had an increased mortality rate for the first three years which subsequently normalised compared to that of the general population. Annual OHCA disease burden in DALY trended downwards from 2010 to 2018. Improved surveillance and OHCA treatment strategies may improve long-term survivorship and decrease its global burden. FUNDING: National Medical Research Council, Singapore, under the Clinician Scientist Award (NMRC/CSA-SI/0014/2017) and the Singapore Translational Research Investigator Award (MOH-000982-01).

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Published In

Lancet Reg Health West Pac

DOI

EISSN

2666-6065

Publication Date

March 2023

Volume

32

Start / End Page

100672

Location

England

Related Subject Headings

  • 4206 Public health
  • 4203 Health services and systems
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Ho, A. F. W., Lim, M. J. R., Earnest, A., Blewer, A., Graves, N., Yeo, J. W., … Singapore PAROS Investigators, . (2023). Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort study. Lancet Reg Health West Pac, 32, 100672. https://doi.org/10.1016/j.lanwpc.2022.100672
Ho, Andrew Fu Wah, Mervyn Jun Rui Lim, Arul Earnest, Audrey Blewer, Nicholas Graves, Jun Wei Yeo, Pin Pin Pek, Ling Tiah, Marcus Eng Hock Ong, and Marcus Eng Hock Singapore PAROS Investigators. “Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort study.Lancet Reg Health West Pac 32 (March 2023): 100672. https://doi.org/10.1016/j.lanwpc.2022.100672.
Ho AFW, Lim MJR, Earnest A, Blewer A, Graves N, Yeo JW, et al. Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort study. Lancet Reg Health West Pac. 2023 Mar;32:100672.
Ho, Andrew Fu Wah, et al. “Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort study.Lancet Reg Health West Pac, vol. 32, Mar. 2023, p. 100672. Pubmed, doi:10.1016/j.lanwpc.2022.100672.
Ho AFW, Lim MJR, Earnest A, Blewer A, Graves N, Yeo JW, Pek PP, Tiah L, Ong MEH, Singapore PAROS Investigators. Long term survival and disease burden from out-of-hospital cardiac arrest in Singapore: a population-based cohort study. Lancet Reg Health West Pac. 2023 Mar;32:100672.

Published In

Lancet Reg Health West Pac

DOI

EISSN

2666-6065

Publication Date

March 2023

Volume

32

Start / End Page

100672

Location

England

Related Subject Headings

  • 4206 Public health
  • 4203 Health services and systems
  • 3202 Clinical sciences